MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'diagnostic'. Sat, 03 Sep 2011 01:56:41 +0100 http://www.medworm.com/index.php?rid=5174617&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpatient-history-found-to-be-key-element-in-making-a-diagnosis%2F2011.08.28 Four out of five doctors agree that they don’t need scans to make the right diagnosis. It’s an old-fashioned concept frequently discussed among ACP members, but the history and physical combined with basic tests is way more important to diagnosis than ordering scans and advanced tests. A recent research letter in the Archives of Internal Medicine makes the case. In the letter, Israeli researchers described a prospective study of 442 consecutive patients admitted from the emergency department in 53 days. A senior resident examined all patients within 24 hours of admission (mean=14), including a history, physical, and review of ancillary test findings done at the emergency department, such as blood and urine tests, electrocardiography, and chest radiography. The resident also rev... Better Health blogs http://www.medworm.com/rss/comments.php?id=5174617 Sun, 28 Aug 2011 18:30:00 +0100 5174617 http://www.medworm.com/index.php?rid=5130744&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffda-approves-ges-newest-ct-scanner%2F2011.08.15 GE Healthcare has received the FDA OK for its Optima CT660 computed tomography (CT) system. The CT660, which is already available in Europe, Latin America and Asia, distinguishes itself by its compact footprint combined with a modular design and low dose imaging. In addition, it is also one of the most energy efficient CT scanners available and has an “environmental design” that eases refurbishment and end-of-life recycling. The scanner itself is scalable from 32 to 128 slices through purchasable options and features automatic table positioning and a color 12-inch integrated gantry display monitor. (more…) *This blog post was originally published at Medgadget* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=5130744 Mon, 15 Aug 2011 21:05:47 +0100 5130744 http://www.medworm.com/index.php?rid=5096208&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fan-alternative-to-a-colonoscopy%2F2011.08.03 Most of us born several decades ago, recall the futuristic book Fantastic Voyage by Isaac Asimov, where a miniaturized crew traveled through a human body to cure a scientist who has a blot clot lodged in his brain. Ironically, miniaturized medical care is now upon us while books are at risk of becoming obsolete. I hope that gastroenterologists won’t become obsolete, at least until my last kid graduates from college. I perform an amazing diagnostic procedure called wireless capsule endoscopy (WCE), when patients swallow a camera. Once swallowed, this miniaturized camera takes its own fantastic voyage through the alimentary canal. The test is used primarily to identify sources of internal bleeding within the 20 feet of small intestine, which are beyond the reach of gastroenterologists’ c... Better Health blogs http://www.medworm.com/rss/comments.php?id=5096208 Wed, 03 Aug 2011 22:30:00 +0100 5096208 http://www.medworm.com/index.php?rid=5077770&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F07%2F28%2Fcbs-news-others-get-nose-job-story-wrong%2F In one of the worst examples of health reporting I’ve seen today, a bunch of news outlets have equated “symptoms of a disorder” with having the disorder itself. It may seem like a subtle difference, but in the world of mental health diagnosis, having a symptom of a disorder is not the same as having the disorder itself. The study in question was conducted on people seeking treatment for a nose job. To assess patients’ psychopathology, the researchers administered a bunch of psychological tests to the patients before their rhinoplasty. One of those tests was the Yale-Brown Obsessive Compulsive Scale modified for body dysmorphic disorder. Now, the researchers only found a 2 percent rate of body dysmorphic disorder (BDD) among the 226 patients they tested. That rate is... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=5077770 Thu, 28 Jul 2011 21:58:34 +0100 5077770 http://www.medworm.com/index.php?rid=5062291&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F07%2F25%2Fbps-on-dsm%2F Some of you may be following the development of the forthcoming fifth revision to the Diagnostic and Statistical Manual of Mental Disorders (DSM), the major book used for psychiatric diagnosis. There has been a lot of criticism due to the secrecy of the process this time around, but the British Psychological Society (BPS), the major mental health organization in the UK, is taking an even more interesting and refreshing angle: criticizing the entire current framework of diagnosis. The DSM takes a medical approach to diagnosis. In short, this means that a ‘patient’ is assumed to have an underlying ‘pathology’ that manifests as various ‘symptoms’ that are assessed to make a ‘diagnosis’ and then apply a ‘treatment’ to said diagnosis. ... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=5062291 Mon, 25 Jul 2011 16:44:58 +0100 5062291 http://www.medworm.com/index.php?rid=5008362&cid=t_139811_113_f&fid=34625&url=http%3A%2F%2Fi.cdn.turner.com%2Fcnn%2F.element%2Fapps%2Fcvp%2F3.0%2Fswf%2Fcnn_416x234_embed.swf%3Fcontext%3Dembed%26amp%3BvideoId%3Dbestoftv%2F2011%2F07%2F08%2Fexp.am.imagine.cup.microsoft.cnn About three months ago, I wrote about the Imagine Cup, an annual student technology competition sponsored by Microsoft, in a commentary for MobiHealthNews. I mentioned a winning project in the U.S. competition, a smartphone-based imaging system that can help diagnose malaria in far-flung corners of the globe. Today, the creators of that system and a few other Imagine Cup participants are in New York for the international finals. A few of the students appeared on CNN’s American Morning with Microsoft CEO Steve Ballmer. CNN said the malaria app is 94 percent accurate, better than the traditional field test for malaria. Another project, Harmonicare, incorporates a tablet computer to add a musical aspect to the “blowing” test used to help patients regain respiratory function ... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=5008362 Fri, 08 Jul 2011 17:26:14 +0100 5008362 http://www.medworm.com/index.php?rid=4992755&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F07%2F02%2Fhow-the-dsm-developed-what-you-might-not-know%2F The Diagnostic and Statistical Manual of Mental Disorders (DSM) is widely known as the bible of psychiatry and psychology. But not many people know how this powerful and influential book came to be. Here’s a brief look at the DSM’s evolution and where we are today. The Need for Classification The origins of the DSM date back to 1840 — when the government wanted to collect data on mental illness. The term “idiocy/insanity” appeared in that year’s census. Forty years later, the census expanded to feature these seven categories: “mania, melancholia, monomania, paresis, dementia, dipsomania and epilepsy.” But there was still a need to gather uniform stats across mental hospitals. In 1917, the Bureau of the Census embraced a publication called the Statistical Manual for ... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4992755 Sat, 02 Jul 2011 10:43:12 +0100 4992755 http://www.medworm.com/index.php?rid=4893605&cid=t_139811_113_f&fid=34625&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FNeilVerselsHealthcareItBlog%2F%7E3%2F0g_GyIRAV-M%2F In just the last few hours, I’ve seen a huge wave of pushback and doubt about Watson, the IBM supercomputer, being used for clinical decision support. Yesterday, I covered a “healthcare leadership exchange” at IBM’s new Healthcare Innovation Lab in downtown Chicago. I posted some of my observations on the EMR and HIPAA blog, and made the case for diagnostic decision support. I also wrote a story for InformationWeek, but that hasn’t run. Instead of posting my story, InformationWeek healthcare editor Paul Cerrato wrote a column about Watson already being “beaten in the medical diagnostics race” by Isabel Healthcare, a diagnostic decision support tool that’s been available for years. I have to admit, he’s right. I first interviewed Isabel ... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=4893605 Sat, 04 Jun 2011 00:37:50 +0100 4893605 http://www.medworm.com/index.php?rid=4841584&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F05%2F18%2Fincreasing-mental-health-awareness-too-much-of-a-good-thing%2F Today is the American Psychological Association’s “Blog Party” in recognition of May being mental health month. The marketing effort behind designating a specific month a time to recognize and help increase awareness of a certain disease, disorder or condition is intended to help people learn more about various medical and mental health concerns. But a few weeks ago, physician H. Gilbert Welch wrote an op-ed in the LA Times that questioned whether the pendulum has swung too far the other way. Have we become a nation of people who will get diagnosed for all sorts of sub-clinical problems at the drop of a hat? Indeed, I think there is a very real danger of that becoming the case. And nowhere is that more likely than in mental health. Dr. Ron Pies talked about some of these... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4841584 Wed, 18 May 2011 10:14:06 +0100 4841584 http://www.medworm.com/index.php?rid=4841687&cid=t_139811_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D265 You have to be pretty excited that 3D mammography was just approved, but the good news does not stop there.  A unique 3D ultrasound technology is also in the FDA approval process.  Screening mammography has been the gold standard for detecting breast cancer for 30 years.  Still, the technology has a false positive rate ranging from 5.5% to 7.4%.  Because of this, patients are referred to ultrasound then MRI to rule out cancer before a biopsy is performed. Warm Bath Ultrasound (WBU) is a new technology designed to produce 3D breast images in less than 10 minutes. It’s based on placing the breast in a warm water bath surrounded by multiple ultrasound transducers, allowing near instantaneous tomographic imaging of the tissue.  Although limited as a screening tool, ultrasound has proven... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4841687 Tue, 17 May 2011 14:06:10 +0100 4841687 http://www.medworm.com/index.php?rid=4803293&cid=t_139811_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D258 T-rays (Terahertz) are not something out of a movie; they are an emerging imaging technology with tissue analysis capabilities.  The technology has been studied for decades but high costs had limited its medical applications.  Commercial applications, such as airport security, have funded rapid advancements in technology and have helped drop the cost significantly.  Now, several companies and research centers are developing imaging systems for clinical trials. Terahertz radiation uses electromagnetic energy that falls between light and microwave radiation.  The technology is non-ionizing, which makes it safer than X-rays, and offers spectral analysis imaging.  It can also penetrate tissue to 3 to 4 cm.  Medical applications include wound care, cancer, and arthritis diagnosis. I asked... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4803293 Mon, 09 May 2011 17:04:39 +0100 4803293 http://www.medworm.com/index.php?rid=4734297&cid=t_139811_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D241 TB has not been a big topic in healthcare media, so I assumed TB was on the decline in the U.S.  However, a recent study concluded that despite the decrease in TB, the death rate has risen up to 50% for ICU patients due to a delay in diagnosis.  The CDC believes this poses a risk for both patients and healthcare workers.  High-volumes have always made cost an issue with screening tests.  A basic test for TB costs $20 to $40; more advanced testing to determine the strain (rifampin resistance) adds another $20 to $30.  These tests also take a couple of days for results, making them of limited use in a hospital environment. The Xpert MTB/RIF test is based on the growing field of molecular diagnostics.  Advanced technology allows the system to provide accurate results from an untreated s... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4734297 Wed, 20 Apr 2011 13:55:44 +0100 4734297 http://www.medworm.com/index.php?rid=4714866&cid=t_139811_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D236 The use of light as a medical diagnostic modality has been evolving since the pulse oximeter was first invented.  The recent FDA approval of the optical coherence tomography imaging system (OCTIS) has taken the use of light as a diagnostic tool another step.  OCTIS is designed to use multiple wavelengths of light to provide magnified cross-sectional images of a suspicious pathology.  This, combined with its 1-mm catheter, will enable it to be a viable tool for lung and GI tract cancers.  Historically, advanced imaging technologies, such as CT and MRI, are used to detect suspicious nodules as small as 1 mm; however, to confirm or rule out cancer, an invasive biopsy is performed. Still, 99% of biopsied lung lesions are negative for cancer. I spoke to Armin Ernst, MD, pulmonologist and ch... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4714866 Thu, 14 Apr 2011 13:34:36 +0100 4714866 http://www.medworm.com/index.php?rid=4723774&cid=t_139811_87_f&fid=34925&url=http%3A%2F%2Fbestyoucanbe.blogspot.com%2F2011%2F04%2Ftwilight-of.html Neurologic disorders, alas, are not going away. The concept of "schizophrenia", however, is shuffling off the stage.Today's obit comes from Kwang-Soo Kim, a stem-cell scientist at McLean Hospital in Belmont, Massachusetts:  "These disorders are not really disorders. There's no such thing as schizophrenia. It's a syndrome. It's a collection of things psychiatrists have grouped together."[1]Just like autism. Autism is a collection of "things" psychiatrists have grouped together, sustained by law, regulation, tradition -- and the current lack of a better alternative.[1] Schizophrenia 'in a Dish': Scientific American 4/13/2011See also:Victory: The war against 20th century psychiatric diagnoses is all but won (Source: Be the Best You can Be) Be the Best You can Be blogs http://www.medworm.com/rss/comments.php?id=4723774 Thu, 14 Apr 2011 10:33:00 +0100 4723774 http://www.medworm.com/index.php?rid=4600580&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F03%2F16%2Ftips-to-find-a-good-enough-doctor-2%2F Inspired from all the comments she received from my interview with her on chronic illness, Dr. Elvira Aletta compiled some suggestions for finding a good-enough doctor. In her previous Psych Central post called Tips to Find a Good-Enough Doctor, she throws out three basic qualities she looks for in a doctor: Expertise, knowledge, intellectual curiosity and all the right credentials. Warm, receptive, a good listener and communicator. The bedside manner thing. A well-run office, with smart, efficient support & medical staff. Then she follows up with a few more points to keep in mind while shopping for a doctor… Here are a few more of Dr. Elvira Aletta’s tips to find a good-enough doctor: If you are in doubt, interview several doctors as if they were applying for a job an... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4600580 Wed, 16 Mar 2011 17:23:01 +0100 4600580 http://www.medworm.com/index.php?rid=4560270&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fidentifying-skin-cancer-with-light%2F2011.03.08 Duke University scientists have been successfully testing a new laser system they developed to identify cancerous skin moles. Two lasers in the system are used to identify the presence of eumelanin in biopsy slices and a future version of the device may work directly without having to sample the mole. According to an article in Science Translational Medicine, “the ratio of eumelanin to pheomelanin captured all investigated melanomas but excluded three-quarters of dysplastic nevi and all benign dermal nevi.” From the press release: The tool probes skin cells using two lasers to pump small amounts of energy, less than that of a laser pointer, into a suspicious mole. Scientists analyze the way the energy redistributes in the skin cells to pinpoint the microscopic locations of diff... Better Health blogs http://www.medworm.com/rss/comments.php?id=4560270 Tue, 08 Mar 2011 20:00:42 +0100 4560270 http://www.medworm.com/index.php?rid=4532213&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-experienced-is-the-radiologist-who-reads-your-mammogram%2F2011.02.28 There’s a new study out on mammography with important implications for breast cancer screening. The main result is that when radiologists review more mammograms per year, the rate of false positives declines. The stated purpose of the research*, published in the journal Radiology, was to see how radiologists’ interpretive volume — essentially the number of mammograms read per year — affects their performance in breast cancer screening. The investigators collected data from six registries participating in the NCI’s Breast Cancer Surveillance Consortium, involving 120 radiologists who interpreted 783,965 screening mammograms from 2002 to 2006. So it was a big study, at least in terms of the number of images and outcomes assessed. First — and before reaching any concl... Better Health blogs http://www.medworm.com/rss/comments.php?id=4532213 Mon, 28 Feb 2011 14:00:57 +0100 4532213 http://www.medworm.com/index.php?rid=4522108&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Femr-and-the-pathologist-a-winning-combo%2F2011.02.25 A pathologist uses the EMR to find out just a little more about the patient whose cerebro-spinal fluid she has under her microscope — and changes her diagnosis: This patient had a diagnosis of plasma cell myeloma with recent acute mental status changes. So the lone plasma cell or two I was seeing, among the lymphs and monos, could indicate leptomeningeal spread of the patient’s disease process. I reversed the tech diagnosis to atypical and added a lengthy comment – unfortunately there weren’t enough cells to attempt flow cytometry to assess for clonality of the plasma cells to cinch the diagnosis. But with the information in the EMR I was able to get a more holistic picture on a couple of cells and provide better care for the patient. I cringe to wonder if I might have blown th... Better Health blogs http://www.medworm.com/rss/comments.php?id=4522108 Fri, 25 Feb 2011 14:00:13 +0100 4522108 http://www.medworm.com/index.php?rid=4498276&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fibm-watson-could-revolutionize-healthcare%2F2011.02.19 If you’ve been watching Jeopardy! over the past couple days, you probably know that IBM’s highly-advanced artificial intelligence software, Watson, has been competing against Jeopardy!’s most successful contestants (and as of Tuesday night, took a commanding lead over the humans, despite having some trouble with United States geography). Besides the amazing ability to power through “Daily Doubles” and answer random trivia in the form of a question, IBM researchers believe that Watson could revolutionize the healthcare industry. From diagnostics to informatics, Watson could quickly search through medical records, clinical documents, and research information for precise answers that would benefit both doctors and patients. Check out the video below to see physic... Better Health blogs http://www.medworm.com/rss/comments.php?id=4498276 Sat, 19 Feb 2011 14:00:16 +0100 4498276 http://www.medworm.com/index.php?rid=4495203&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmri-safe-pacemakers-available-in-u-s-hospitals-soon-what-it-means-for-heart-patients%2F2011.02.18 This was the Guest Blog at Scientific American on February 16th, 2011. New wave of MRI-safe pacemakers set to ship to hospitals This week Medtronic will begin shipping to hospitals in the United States the first pacemaker approved by the FDA as safe for most MRI scans. For consumers, it is a significant step in what is expected to be a wave of new MRI-compatible implanted cardiac devices. But this is an example of one technology chasing another and the one being chased, the MRI scanner, is changing and is a step ahead of the new line of pacemakers. The pacemaker approved for U.S. distribution is Medtronic’s first-generation pacemaker with certain limitations, while its second-generation MRI-compatible pacemaker is already in use in Europe where approval for medical devices is not as dem... Better Health blogs http://www.medworm.com/rss/comments.php?id=4495203 Fri, 18 Feb 2011 21:00:00 +0100 4495203 http://www.medworm.com/index.php?rid=4482762&cid=t_139811_88_f&fid=38153&url=http%3A%2F%2Fwww.ozemedicine.com%2Fblog%2F%3Fp%3D942 The recently published retrospective Canadian study of 5 year cancer risk following heart attack in 1996-2006 seems to demonstrate a consistent 3% increased risk in cancer per 10 milliSv radiation dose when adjusted for sex, age, comorbities (but strangely, not for smoking status, nor for actual measured radiation dosage but for presumed, estimated dosage based on investigations and procedures which were billed). Nevertheless, the increased risk seems consistently increased as radiation dose increases and thus the results may be plausible. Given the average age of these patients being ~61 years, some 14% were diagnosed with new cancers in the 2-5 years following their AMI, thus a relative increased risk of 3% per 10mSv is something to stress us! See here for the paper. This will inevitably... Oz E Medicine - emergency medicine in Australia blogs http://www.medworm.com/rss/comments.php?id=4482762 Wed, 16 Feb 2011 09:18:57 +0100 4482762 http://www.medworm.com/index.php?rid=4477760&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fin-the-er-with-abdominal-pain-lower-your-diagnosis-expectations%2F2011.02.15 Abdominal pain is the bane of many emergency physicians. Recently, I wrote how CT scans are on the rise in the ER. Much of those scans look for potential causes of abdominal pain. In an essay from Time, Dr. Zachary Meisel discusses why abdominal pain, in his words, is the doctor’s “booby prize.” And when you consider that there are 7 million visits annually by people who report abdominal pain, that’s a lot of proverbial prizes. One reason is the myriad of causes that lead bring a patient to the hospital clutching his abdomen. It can range from something as relatively benign as viral gastroenteritis where a patient be safely discharged home, to any number of “acute” abdominal problems necessitating surgery. But more importantly, we need to consider how limited doctors actually a... Better Health blogs http://www.medworm.com/rss/comments.php?id=4477760 Tue, 15 Feb 2011 16:00:19 +0100 4477760 http://www.medworm.com/index.php?rid=4445805&cid=t_139811_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2Fc2ECFg2qEN8%2F The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4445805 Mon, 07 Feb 2011 08:38:09 +0100 4445805 http://www.medworm.com/index.php?rid=4411563&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F01%2F28%2Fbest-of-our-blogs-january-28-2011%2F There is a ton of things that can touch us in a week. In one day alone, I can easily get lost in every day activities and not only in what happens to us and around us, but what happens within us. One of my greatest fears is that I will allow too much outside noise to silence the most important one. My own. As I reflect on another week past, I recall the President’s State of the Union address, a conversation with a friend, a dream I had beckoning me in the morning, an episode of The View where Michael Jackson’s sister Rebbie Jackson talks about her daughter’s bipolar disorder diagnosis. It’s so much to digest that I can easily lose sight of the way I’m feeling right now. I can too easily forget what I’m doing, how I’m interacting with those around m... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4411563 Fri, 28 Jan 2011 13:05:27 +0100 4411563 http://www.medworm.com/index.php?rid=4372044&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-good-is-your-doctor-at-diagnosing-you%2F2011.01.19 We’ve all been there. It often starts with some kind of recurring pain or dull ache. We don’t know what’s causing the pain or ache. During the light of day we tell ourselves that it’s nothing. But at 3:00am when the pain wakes you, worry sets in: “Maybe I have cancer or heart disease or some other life-ending ailment.” The next day you make an appointment to see your doctor. So now you’re sitting in the exam room explaining this scenario to your doctor. Based on your previous experience, what’s the first thing your doctor would do? A. Order a battery of tests and schedule a follow-up appointment. B. Put you in a patient gown and conduct a thorough physical examination, including asking you detailed questions about your complaint before ordering any test... Better Health blogs http://www.medworm.com/rss/comments.php?id=4372044 Wed, 19 Jan 2011 22:00:07 +0100 4372044 http://www.medworm.com/index.php?rid=4372047&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fshould-doctors-be-allowed-to-self-refer%2F2011.01.19 Federal law generally prohibits physicians from referring their own patients to a diagnostic facility in which they have an ownership issue — a practice called “self-referral” — unless the facility is located in their own practice. This exemption exists to allow patients with access to a laboratory test, X-ray, or other imaging test at the same time and place as when patients are seeing their physician for an office visit. Less inconvenience and speeder diagnosis and treatment — what could be wrong with that? Much, say the critics, if it leads to overutilization and higher costs and doesn’t really represent a convenience to patients. This is the gist of two studies by staff employed by the American College of Radiology, published in the December issue of Health Affa... Better Health blogs http://www.medworm.com/rss/comments.php?id=4372047 Wed, 19 Jan 2011 16:00:00 +0100 4372047 http://www.medworm.com/index.php?rid=4355718&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpsychiatric-diagnosis-and-the-dsm-5-controversy%2F2011.01.16 I’ve followed in bits and pieces — sometimes for Shrink Rap, sometimes because the issues fill my email inbox, sometimes because there’s no escape. Oh, and lots of the players have familiar names. In the December 27th issue of Wired magazine, Gary Greenberg writes a comprehensive article on the debates around the revision of the American Psychiatric Association’s (APA) upcoming revision of the Diagnostic and Statistical Manual (DSM) entitled “Inside the Battle to Define Mental Illness.” Do read it. Here’s an excerpt: I recently asked a former president of the APA how he used the DSM in his daily work. He told me his secretary had just asked him for a diagnosis on a patient he’d been seeing for a couple of months so that she could bill the insur... Better Health blogs http://www.medworm.com/rss/comments.php?id=4355718 Sun, 16 Jan 2011 17:00:00 +0100 4355718 http://www.medworm.com/index.php?rid=4343129&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fglaucoma-testing-through-the-eyelid%2F2011.01.13 Intraocular pressure is usually measured by applying a force on the cornea using a tonometer. Although sufficiently accurate, tonometers are only used in ophthalmologist offices and so don’t measure intra-day pressures. They also fail with people post cataract surgery that have a thicker cornea. Researchers at University of Arizona have developed a new device that measures intraocular pressure through the eyelid. From the University of Arizona College of Engineering: The self-test instrument has been designed in Eniko Enikov’s lab at the UA College of Engineering. Gone are the eye drops and need for a sterilized sensor. In their place is an easy-to-use probe that gently rubs the eyelid and can be used at home. “You simply close your eye and rub the eyelid like you might c... Better Health blogs http://www.medworm.com/rss/comments.php?id=4343129 Thu, 13 Jan 2011 16:00:03 +0100 4343129 http://www.medworm.com/index.php?rid=4337937&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2F%25e2%2580%259cjust-in-case%25e2%2580%259d-heart-tests-can-they-do-more-harm-than-good%2F2011.01.12 Here’s an important equation that all of us — doctors include — should know about healthcare, but don’t: More ≠ Better “More does not equal better” applies to diagnostic procedures, screening tests meant to identify problems before they appear, medications, dietary supplements, and just about every aspect of medicine. That scenario is spelled out in alarming detail in the Archives of Internal Medicine. Clinicians at the Cleveland Clinic describe the case of a 52-year-old woman who went to her community hospital because she had been having chest pain for two days. She wasn’t having symptoms of a heart attack, such as shortness of breath, unexplained nausea, or a cold sweat, and her electrocardiogram and other tests were fine. The woman’s doctors concluded that her ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4337937 Wed, 12 Jan 2011 16:00:10 +0100 4337937 http://www.medworm.com/index.php?rid=4314049&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F01%2F05%2Fmeasuring-your-character-strengths%2F When we think of psychology, we tend to think disorders, deficits and distress. Abnormal psychology automatically comes to mind. But, of course, there are several types of psychology. One of them, positive psychology, takes a different approach. It focuses on how humans flourish. Specifically, positive psychology “is the scientific study of the strengths and virtues that enable individuals and communities to thrive,” according to the Positive Psychology Center at the University of Pennsylvania, home to positive psychology’s founder, Martin E.P. Seligman. It studies three principle areas, according to Seligman: positive emotions (such as happiness and hope), positive individual traits (such as strength, resilience and creativity) and positive institutions (such as better communities, ... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4314049 Wed, 05 Jan 2011 18:06:47 +0100 4314049 http://www.medworm.com/index.php?rid=4302125&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ftest-results-delivered-to-your-cellphone-via-a-disposable-test-strip%2F2010.12.31 GENTAG, Inc. has announced a new diagnostic platform which uses near field communication (NFC) technology to transmit test results from a disposable test strip to a patient’s cellphone. Once results have been sent to a phone, they can then be uploaded to internet-connected EMR systems. The company claims their platform can test for pregnancy, HIV/AIDS, pathogens, and a number of different cancers, and monitor glucose, fever, as well as deliver drugs. From the press release: GENTAG started with well-established immunoassay technology and made it wireless and compatible with Near Field Communication (NFC) technology, which enables consumers to use their cell phones as diagnostic tools to instantly test for pathogens, allergens or common medical conditions at any time, no matter where ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4302125 Fri, 31 Dec 2010 16:10:57 +0100 4302125 http://www.medworm.com/index.php?rid=4294594&cid=t_139811_87_f&fid=34925&url=http%3A%2F%2Fbestyoucanbe.blogspot.com%2F2010%2F12%2Fvictory-war-against-20th-century.html I started rabble rousing about the fallacies of psychiatric classifications (diagnoses, nosologies) about eight years ago. Five years ago I went public, since that time I've labeled 29 posts as "diagnostic definition" related [1] including my most recent rant...... We're due for another DSM edition, but I doubt that will be any better.The good news is that in the last 8 years it's become clear to every researcher that all of the common neurospychiatric conditions, from "ADHD" to "ODD" to "Autism" to "Aspergers" to "Bipolar disorder" to "Schizophrenia" are very rough categorizations of thousands of different "phenotypes" (where a phenotype is the end-result of the interaction between genes and environment) that are themselves dynamic over the lifetime of the brain. (Even after adolescence... Be the Best You can Be blogs http://www.medworm.com/rss/comments.php?id=4294594 Wed, 29 Dec 2010 00:45:00 +0100 4294594 http://www.medworm.com/index.php?rid=4294806&cid=t_139811_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D127 Ultrasound contrast first appeared in the 1990s and now, evolving microbubble contrast agents, which are relatively low-cost and safe, are expanding the role of ultrasounds in diagnostic medicine. Microbubbles consist of shells ranging from 1-4 micrometers in diameter that are injected with a gas and have the ability to reflect ultrasound waves.  Because microbubbles reflect ultrasound waves differently than tissue, a unique sonogram is produced with these contrast agents.  Currently, their primary focus is in echocardiography for the diagnosis of cardiac conditions but they are evolving to other applications, such as tumor identification and liver diseases.  Additionally, microbubbles can be used to deliver drug therapy to a specific site. I spoke to Roy Filly, MD, professor emeritus, ... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4294806 Mon, 27 Dec 2010 14:35:55 +0100 4294806 http://www.medworm.com/index.php?rid=4275325&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Freassuring-patients-about-ct-scans-and-radiation-risks%2F2010.12.20 Emergency patients with acute abdominal pain feel more confident about medical diagnoses when a doctor has ordered a computed tomography (CT) scan, and nearly three-quarters of patients underestimate the radiation risk posed by this test, reports the Annals of Emergency Medicine. “Patients with abdominal pain are four times more confident in an exam that includes imaging than in an exam that has no testing,” said the paper’s lead author. “Most of the patients in our study had little understanding of the amount of radiation delivered by one CT scan, never mind several over the course of a lifetime. Many of the patients did not recall earlier CT scans, even though they were listed in electronic medical records.” Researchers surveyed 1,168 patients with non-traum... Better Health blogs http://www.medworm.com/rss/comments.php?id=4275325 Mon, 20 Dec 2010 22:00:00 +0100 4275325 http://www.medworm.com/index.php?rid=4233264&cid=t_139811_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D111 Noninvasive, quick, accurate, and at a lower cost.  If that doesn’t make the top of the list, then what does?  Not that long ago, I was asked by the CEO of a forward-thinking hospital to share my views on emerging medical technology because the hospital’s board of directors was looking for a second opinion on their wish list of high-dollar new technology.  Interestingly enough, my presentation coincided perfectly with a recently-recruited cardiologist’s presentation that preceded mine.  For years, the “gold standard” for diagnosing chest pain has been a cath lab procedure.  However, along with being invasive and costly, it is a time-consuming procedure.  Coronary CT angiography has been an evolving technology for years.  Early 8- and 16-slice systems offered limited abilit... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4233264 Mon, 06 Dec 2010 14:52:15 +0100 4233264 http://www.medworm.com/index.php?rid=4219747&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fnarcissism-no-longer-a-personality-disorder%2F2010.12.01 Via an article in The New York Times entitled “Narcissism No Longer a Psychiatric Disorder”: Narcissistic personality disorder, characterized by an inflated sense of self-importance and the need for constant attention, has been eliminated from the upcoming manual of mental disorders, which psychiatrists use to diagnose mental illness. As Charles Zanor reports in today’s Science Times, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders — due out in 2013 and known as D.S.M.-5 — has eliminated five of the 10 personality disorders that are listed in the current edition. The best known of these is narcissistic personality disorder. So, blogging is normal then? Kinda takes the fun out of it… *This blog post was originally published at Gr... Better Health blogs http://www.medworm.com/rss/comments.php?id=4219747 Wed, 01 Dec 2010 15:00:18 +0100 4219747 http://www.medworm.com/index.php?rid=4214190&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F11%2F30%2Fpersonality-disorders-shakeup-in-dsm-5%2F Narcissistic personality disorder is slated for removal from the next edition of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, to be published in 2013. So notes Charles Zanor in yesterday’s New York Times. But for some reason, Zanor glossed over the loss of four other personality disorders in the shakeup too — Paranoid, Schizoid, Histrionic and Dependent Personality Disorders. (Schizotypal, Antisocial, Borderline, Avoidant and Obsessive-Compulsive Personality Disorders will remain in the new revision.) Their intended replacements? “The Work Group recommends that [these disorders] be represented and diagnosed by a combination of core impairment in personality functioning and specific pathological personality traits, rather than as a specific ty... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4214190 Tue, 30 Nov 2010 21:45:38 +0100 4214190 http://www.medworm.com/index.php?rid=4172165&cid=t_139811_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D91 EKGs have been a mainstay for assessing a fetus’ health since the early 1900s.  But, due to interference from the maternal EKG signal, physicians are not able to get a true waveform, which is critical in diagnosing arrhythmia or elevated ST segment in a fetus.  According to Dr. Nina Gotteiner, MD, pediatric cardiologist, associate professor of pediatrics, Feinberg School of Medicine, Northwestern University in Chicago, IL, “If we can identify a fetal arrhythmia, it is very treatable and we can affect the outcome.” Currently, fetal EKGs are acquired through a scalp electrode, which limits the technology’s ability to acquire the data in a non-labor setting.  However, evolving noninvasive fetal EKG technology is designed to accurately separate fetal and maternal EKG signals.  Depe... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4172165 Tue, 16 Nov 2010 15:42:00 +0100 4172165 http://www.medworm.com/index.php?rid=4168210&cid=t_139811_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2Fl2OCKDBmYig%2F In response to recent efforts to restrict the dissemination of academic research generated by contracts, the American Association of University Professors is developing new guidelines for colleges and faculty who receive corporate financing for research. The move comes after recent attempts by BP and federal agencies using Natural Resource Damage Assessment program. The disclosure was made in the recent issue of AAUP’s Academe magazine, which carries several articles, including one about conflicts of interest standards at medical journals (read here), another that reviews pharmaceutical industry influence on the Diagnostic and Statistical Manual of Mental Health Disorders (see this) and an essay detailing similar concerns in Canada, where the Canadian Association of University Profes... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4168210 Mon, 15 Nov 2010 14:11:41 +0100 4168210 http://www.medworm.com/index.php?rid=4098285&cid=t_139811_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2010%2F10%2Funregulated-dtcg-saved-my-life.html Ok, so if Ellen Matloff hasn't flipped her bobbed haircut, 99245 without 60 min of MD care-insurance billing head yet, then this story will make her and the rest of the counselors who get mad when untrained MDs do BRCA testing flip out.A woman's husband on DNADay takes advantage of 23andMe's rock bottom 99 USD fee. Clearly intended to double their database.....which it didOnly to have her HUSBAND open her results andWHAMMO! You are a BRCA1 carrier! Mazel Tov! Not exactly the "fun" he had been looking for when he saw that flyer.....Why does Myriad market to doctors? Their stance "We are missing a ton of BRCA mutations out there"I agree.So you would think I am happy that an unregulated DTCG testing company that the FDA pilloried finds a medically valid BRCA1 mutation that wasn't suggested by... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=4098285 Fri, 22 Oct 2010 01:11:00 +0100 4098285 http://www.medworm.com/index.php?rid=4060591&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdisease-detected-in-exhaled-breath%2F2010.10.12 A new sensor developed at Stony Brook University may become a clinically useful tool for detecting disease biomarkers in breath. The nanoprobe-based technology is currently able to detect acetone, but should be modifiable to spot other compounds. From the study abstract: This paper describes a sensor nanotechnology suitable for non-invasive monitoring of a signaling gas, such as acetone, in exhaled breath. This is a nanomedicine tool comprised of a selective acetone nanoprobe working on the principle of ferroelectric poling sensing, and a microelectronics circuit for comparing the actual sensor signal to a predetermined threshold value, displaying the result using LED signals. This on/off type non-invasive diagnostics platform technology is based on nanotechnology, gives a fast response, i... Better Health blogs http://www.medworm.com/rss/comments.php?id=4060591 Tue, 12 Oct 2010 12:00:13 +0100 4060591 http://www.medworm.com/index.php?rid=4031305&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F10%2F04%2Fits-all-in-your-head-living-with-chronic-illness%2F Somewhere I read that properly diagnosing a chronic illness can take from two to three years. Many of you wait even longer. In the meantime, while the doctors scratch their heads, we’re expected to be happy we’re alive. And that’s if they don’t write us off with “It’s psychological.” It took a year and three doctors before I was diagnosed with scleroderma. Just remembering what I went through during that year-from-hell gets my blood boiling and I know I was one of the lucky ones. If you are experiencing symptoms but don’t have a diagnosis yet, here are some tips that I hope will help you get through this trying time a little easier. Trust yourself. You are not crazy. Physicians have referred many people to me before they had a diagnosis, even... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4031305 Mon, 04 Oct 2010 23:11:56 +0100 4031305 http://www.medworm.com/index.php?rid=4013258&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F09%2F29%2Ffraser-kirk-and-adjustment-disorders%2F In Australia, David Jones’ publicist Kristy Fraser-Kirk is suing the company she works for and its former CEO Mark McInnes for sexual harassment. David Jones is sort of like Macy’s, except it’s based in Australia. According to news reports, Ms. Fraser-Kirk, 27, is suing David Jones, Mark McInnes and nine directors of the company. She is seeking compensation for a number of different claims, including breach of contract, as well as punitive damages of $37 million. Not exactly chump change. But then again, maybe that’s what it takes to send a clear message about how sexual harassment will not be tolerated in the modern workplace. But due to the publicity surrounding the case in Australia, she’s now making a new novel claim — that the publicity has led to a... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4013258 Wed, 29 Sep 2010 10:20:49 +0100 4013258 http://www.medworm.com/index.php?rid=3994012&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F09%2F22%2Fantidepressants-useless-an-interview-with-glenn-treisman%2F I’m still bothered by all the hype awhile back about antidepressants not working any better than sugar pills (otherwise known as placebo) because I know that the people who need treatment — possibly those that will go on to take their lives — read that story and decided there was no hope in medicine. That’s why I like to publish insightful articles like the one I found in John Hopkin’s newsletter, “Hopkins Brain Wise.” They included an interview with Glenn Treisman, professor of psychiatry and internal medicine who is best known internationally for his care of HIV-infected patients who also suffer from a psychiatric illness. Here’s the interview… Q. These studies are dangerous, you say. Dr. Treisman: Ten to 20 percent of people with ma... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3994012 Wed, 22 Sep 2010 10:30:52 +0100 3994012 http://www.medworm.com/index.php?rid=3993814&cid=t_139811_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F09%2F22%2Fjournal-of-the-american-medical-association-2010-vol-304-no-11%2F This article examines whether recent experience with clinical problems provokes availability bias (overestimation of the likelihood of a diagnosis based on the ease with which it comes to mind) resulting in diagnostic errors and whether reflection (structured reanalysis of the case findings) counteracts this bias. An NHS Athens is required to access this article, alternatively contact the Library for a copy. Filed under: Athens Password, Current Awareness, E-Journals, Journals Tagged: Bias, Diagnostic Errors, Professional Education, United States (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3993814 Wed, 22 Sep 2010 06:24:34 +0100 3993814 http://www.medworm.com/index.php?rid=3982010&cid=t_139811_87_f&fid=34925&url=http%3A%2F%2Fbestyoucanbe.blogspot.com%2F2010%2F09%2Frethinking-neuropsychiatric-diagnoses.html I started bemoaning the classification (aka ontology, nosology) of neuropsychiatric disorders about 8 years ago. I'm not the only one. One of the things I liked about Greene's Explosive Child book is that he is clearly unimpressed with the DSM IV nosology.We're due for another DSM edition, but I doubt that will be any better.The good news is that in the last 8 years it's become clear to every researcher that all of the common neurospychiatric conditions, from "ADHD" to "ODD" to "Autism" to "Aspergers" to "Bipolar disorder" to "Schizophrenia" are very rough categorizations of thousands of different "phenotypes" (where a phenotype is the end-result of the interaction between genes and environment) that are themselves dynamic over the lifetime of the brain. (Even after adolescence, we see maj... Be the Best You can Be blogs http://www.medworm.com/rss/comments.php?id=3982010 Sat, 18 Sep 2010 19:30:00 +0100 3982010 http://www.medworm.com/index.php?rid=3961813&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmammography-wars-an-important-discussion-to-keep-alive%2F2010.09.12 This is a thoughtful “sounding board” piece in the New England Journal of Medicine this week: Lessons from the Mammography Wars. It is so important to keep this discussion alive. The miscommunication that took place last November of what the U.S. Preventive Services Task Force tried to convey, and the complicity of some news organizations in adding to that confusion, provide lessons from which we simply must learn to do better. *This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3961813 Mon, 13 Sep 2010 03:26:23 +0100 3961813 http://www.medworm.com/index.php?rid=3942881&cid=t_139811_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FkWg4LfO-GBo%2Foig-imaging-preauthorization-may-be-handled-by-hospital-for-referring-docs-and-patients.html The OIG released an advisory opinion at the end of last month OK'ing a hospital's proposal to provide insurance pre-authorization srevices free of charge to patients and physicians.  This is an issue that has long vexed folks in the imaging world.  Clearly, this is a free service provided to referral sources (to the extent they are obligated by contract with third party payors to obtain the pre-authorization before referring a patient for an MRI, for example), so why is the OIG OK with it?  In the opinion, the OIG blesses the arrangement for four reasons: The arrangement doesn't target specific referring docs, so the pre-authorization service will be provided for patients of docs who are contractually bound to handle it themselves, as well as for patients of those who aren't, and t... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3942881 Tue, 07 Sep 2010 18:17:13 +0100 3942881 http://www.medworm.com/index.php?rid=3929234&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffda-actively-monitoring-medical-and-healthcare-apps%2F2010.09.02 Bradley Merrill Thompson, an attorney with expertise in the FDA approval process for medical devices, is stating that the FDA is actively monitoring app stores on various platforms. Regulating medical devices and health care-related applications falls under the FDA’s jurisdiction. James Kendrick from JkOnTheRun spoke with Thompson, where he stated the following: The FDA is actively engaged in surveillance of various app stores to see if apps should trigger their involvement. Applications where a smartphone is connected in any way to imaging are under scrutiny, in particular. Any app that is used to transmit images to a medical facility requires FDA approval. By “various app stores,” Thompson is likely referring to the App store [Apple], Palm App Catalog [Web OS], App World [BlackBe... Better Health blogs http://www.medworm.com/rss/comments.php?id=3929234 Thu, 02 Sep 2010 12:00:10 +0100 3929234 http://www.medworm.com/index.php?rid=3885347&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ftestosterone-for-anti-aging-in-men-a-medical-fraud%2F2010.08.19 On the car radio, I have several times happened upon “infomercial” programs touting the benefits of testosterone replacement therapy for men, broadcast by doctors who specialize in prescribing the drugs. They have lots of wonderful stories about men who feel younger, happier, and more vigorous because of their macho remedies. It’s a tribute to the power of the placebo. I have been reviewing John Brinkley’s goat gland scam for a presentation on medical frauds. In an era before the isolation of the hormone testosterone, Brinkley transplanted goat testes into human scrotums in an attempt to treat impotence and aging. We are more sophisticated today — but not much. Longevity clinics and individual practitioners are offering testosterone to men as a general pick-me-up and anti-agi... Better Health blogs http://www.medworm.com/rss/comments.php?id=3885347 Thu, 19 Aug 2010 12:00:29 +0100 3885347 http://www.medworm.com/index.php?rid=3876650&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdoctors-in-cubicles-a-barrier-to-patient-care%2F2010.08.17 I present interesting cases to colleagues often because it’s educational and good for patient care and because I like to. But it has been many years since I was mandated to present a case. It seems that I’m not the only doctor exasperated by a pesky new barrier to patient care: Doctors in cubicles. An old friend and mentor, Dr. Richard Kovacs, now chair of the American College of Cardiology’s Board of Governors (and IU guy), has written about these same pre-certification barriers. Dr. Kovacs, being a professor and distinguished ACC official, kindly terms these obstructionists “radiology benefit managers” (RBMs). (more…) *This blog post was originally published at Dr John M* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3876650 Tue, 17 Aug 2010 22:00:00 +0100 3876650 http://www.medworm.com/index.php?rid=3845080&cid=t_139811_87_f&fid=34925&url=http%3A%2F%2Fbestyoucanbe.blogspot.com%2F2010%2F08%2Fcognitive-evaluation-and-motivation.html One of my sons has substantial measured cognitive disabilities including base IQ and a range of social functions. By most recent evaluations he's borderline "mentally retarded". (A nasty phrase that's enshrined by legal statutes. Of course there's no true binary state, this is all continua.)Which is why our titanic struggles over his misuse of internet resources are puzzling. This ought to be the mismatch of the decade. In every measure of knowledge and cognitive measurement there should be no contest between him and me.And yet it is a struggle. Mostly I win, but he wins some too. He's proven OS X Parental Controls, for example, are utterly broken. (I have more to write about iPhone for special needs adolescence. There's more promise there, starting with disabling Safari and YouTube.)Yes, ... Be the Best You can Be blogs http://www.medworm.com/rss/comments.php?id=3845080 Mon, 09 Aug 2010 04:46:00 +0100 3845080 http://www.medworm.com/index.php?rid=3806026&cid=t_139811_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2Fg72jSWkDSpc%2F Hello, everyone, and top of the morning to you. ‘Tis a shiny day here on the Pharmalot corporate campus, where we look forward to a relaxing weekend of reading, walking our official Pharmalot mascots and frolicking with the shortest of short people. What about you? Any special plans? An afternoon at the beach? A night out with someone special? How about a good movie? Whatever you do, have a great time. Meanwhile, here are some tidbits. Stay in touch and see you soon… Charles River Abandons Plan To Buy WuXi (Outsourcing Pharma) Sanofi’s Viehbacher Tries To Cope (Associated Press) Obese Patients Lose Weight On Orexigen Drug (Reuters) Merck’s Dutch Employees Go To Court Over Job Cuts (Dow Jones) Test Designed To Screen Resistance To Gleevec (Reuters) FDA Finds Problems... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3806026 Fri, 30 Jul 2010 11:57:04 +0100 3806026 http://www.medworm.com/index.php?rid=3794772&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fminnesotans-get-more-lower-back-mris-why%2F2010.07.27 Kudos to Christopher Snowbeck and the St. Paul Pioneer Press for digging into new Medicare data to report that the state the newspaper serves is out of whack with the rest of the country in how many expensive MRI scans are done on Minnesotans’ bad backs. Snowbeck artfully captures the predictable rationalization and defensive responses coming from locals who don’t like what the data suggest. Because what they suggest is overuse leading to overtreatment. So here’s one attempt a provider makes to deflect the data: “The Medicare billing/claims data, which this report is generated from, would not capture conversations between a patient and provider that may have addressed alternative therapies for lower back pain,” said Robert Prevost, a spokesman for North Memor... Better Health blogs http://www.medworm.com/rss/comments.php?id=3794772 Tue, 27 Jul 2010 20:00:39 +0100 3794772 http://www.medworm.com/index.php?rid=3780355&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fbreast-cancer-diagnosis-and-treatment-can-women-trust-it%2F2010.07.22 The news wasn’t good this week for women concerned about breast cancer. First came the story that some women were diagnosed with breast cancer, very early stage, had treatment –- including disfiguring surgery -– and then found out they never had cancer in the first place. The pathologist goofed, maybe even a second pathologist also misread the biopsies. How does this happen? Not surprisingly it comes back to the clinical experience of the doctor. Properly diagnosing breast cancer, whether through radiology scans or pathology biopsies is not always easy. And in many communities the general radiologists and pathologists just don’t have enough specialized experience. This leads to mistakes, especially when the suggestions of possible cancer are subtle and minute. (more…) ... Better Health blogs http://www.medworm.com/rss/comments.php?id=3780355 Thu, 22 Jul 2010 21:00:33 +0100 3780355 http://www.medworm.com/index.php?rid=3776378&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Flife-without-a-mental-disorder-is-it-possible%2F2010.07.21 There’s a noteworthy column in Psychiatric Times, “Normality Is an Endangered Species: Psychiatric Fads and Overdiagnosis,” by Allen Frances, M.D. He was chair of the task force that worked on the Diagnostic & Statistical Manual — DSM-IV — one edition of the “bible of psychiatry.” He is professor emeritus of psychiatry at Duke University School of Medicine. There’s a lot of common ground between what Dr. Frances writes and what Dr. Daniel Carlat (the subject of an earlier blog posting) writes about. Dr. Frances is concerned about the directions that might be taken in the authoring of DSM-V, now underway. Excerpts: “Fads in psychiatric diagnosis come and go and have been with us as long as there has been psychiatry. The fads meet a d... Better Health blogs http://www.medworm.com/rss/comments.php?id=3776378 Wed, 21 Jul 2010 23:00:01 +0100 3776378 http://www.medworm.com/index.php?rid=3750058&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fa-skin-cancer-detecting-camera%2F2010.07.13 Yanko, the design blog we highlight occasionally, shows us a device design by Antonia Haaf meant to automatically detect melanoma, called Black Skin Cancer. Details are vague, as they usually are with concept designs, but the device is meant to be placed over a suspected legion and “[analyze] 2D and 3D characteristics from melanocytic lesions with just one shot. Using a secret algorithm, the device recognizes critical lesions such as the nodular melanome.” While pretty, commenter Widepers on the site points out: “Frankly, a magnifying glass and the skin doctor’s email might do the trick just as well.” Yanko Designs: Detector VS Black Skin Cancer *This blog post was originally published at Medgadget* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3750058 Tue, 13 Jul 2010 23:14:26 +0100 3750058 http://www.medworm.com/index.php?rid=3733124&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F07%2F07%2Fare-you-a-picky-eater-or-selective-eater%2F As kids, many of us engaged in what our parents called “picky eating” — “Don’t be such a picky eater — try it, you might like it!” For whatever reasons, most kids grow out of most of their picky eating habits and learn to try new foods. Some of us may have a few food hangups, avoiding certain popular foods like the plague. But for most, eating different foods is part and parcel of the culinary experience. Some adults, however, don’t grow out of their picky eating habits and, in fact, it may sometimes get even worse as they grow older. Adults with picky eating habits (also known as “selective eating”) may find it more difficult to eat in social situations, because of the limited choices on their own personal food menu. Nobody knows... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3733124 Wed, 07 Jul 2010 17:45:19 +0100 3733124 http://www.medworm.com/index.php?rid=3714184&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdetecting-depression-in-online-text-and-blogs%2F2010.06.30 In a Thought Police kind of way, a new computer program can detect depression through your online writing. Researchers at Ben-Gurion University of the Negev, in Beer-Sheva, Israel, have developed a program that detects depression in text without obvious terms like “depression” or “suicide.” In a sample of 200 positively-identified texts out of 300,000 which were screened by the program, there was a 78 percent agreement between the program and a panel of psychologists. (more…) *This blog post was originally published at Medgadget* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3714184 Wed, 30 Jun 2010 20:00:21 +0100 3714184 http://www.medworm.com/index.php?rid=3706670&cid=t_139811_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FNf6GszCZ5So%2F By Phyllis Greenberger. I just love this—it happens every time. Leave it to the news media to decide whether something is a real health issue or not. That they know little or nothing about the medical condition doesn’t stop them. The latest example is Hypoactive sexual desire disorder (HSDD), a condition that affects as many as 20% of women. It is a loss of desire or libido without any other concurrent medical condition. But, if these journalists (and I use that term loosely) haven’t heard of a condition, especially this one because it has to do with female sexual dysfunction, they are sure a drug company made it up. I heard this with PMDD, fibromyalgia, restless leg syndrome, chronic fatigue syndrome. The media and a few doctors said there was no such thing in each of these situatio... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=3706670 Mon, 28 Jun 2010 10:57:55 +0100 3706670 http://www.medworm.com/index.php?rid=3679828&cid=t_139811_114_f&fid=34648&url=http%3A%2F%2Fhealthblawg.typepad.com%2Ffiles%2Fmike-barber-interview-w-david-harlow-on-healthblawg-062010.mp3 What if you could improve health care across the three intransigent parameters of cost, access and quality by 15%?  That's the challenge GE has set out for itself in the form of its current five-year Healthymagination campaign, and it's investing $6 billion in the effort.  I caught up with GE's VP for Healthymagination, Mike Barber, recently, and I invite you to listen in on our conversation about GE's efforts in the US and globally, within GE's health care business unit and beyond, to roll out this major investment -- which, obviously, GE expects to yield a return in the future.The audio file of my interview with Mike Barber (about 20 minutes long) is available for listening or download:  A full transcript is at the end of this post (and in the linked Mike Barber, VP, Healt... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3679828 Mon, 21 Jun 2010 03:07:01 +0100 3679828 http://www.medworm.com/index.php?rid=3676831&cid=t_139811_131_f&fid=35007&url=http%3A%2F%2Fbooks.mcgraw-hill.com%2Fmedical%2Fommbid%2Fblog%2F%3Fp%3D1314 This study describes a “high-throughput, sensitive, and reproducible method for target-based metabolomics studies” which can quantitatively profile hundreds of known metabolites. posted by Yannis Trakadis (Source: The OMMBID Blog) The OMMBID Blog blogs http://www.medworm.com/rss/comments.php?id=3676831 Fri, 18 Jun 2010 17:04:19 +0100 3676831 http://www.medworm.com/index.php?rid=3635862&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F06%2F07%2Fdsm-5-sleep-disorders-overhaul%2F The DSM-5 Sleep Disorders workgroup has been especially busy. They are calling for a nearly complete overhaul of the sleep disorders category in the Diagnostic and Statistical Manual of Mental Disorders (“DSM”). According to a presentation at the annual meeting of the American Psychiatric Association in May, Charles Reynolds, MD, suggested that the reworking of this category will make sleep problems easier for professionals to diagnose and discriminate between different sleep disorders. He stated that the current DSM-IV puts too much emphasis on presumed causes of symptoms, something that the rest of the DSM-IV does not do. Bringing the sleep disorder section more in line with the other sections in the DSM should make it less confusing. Primary and commonly diagnosed sleep diso... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3635862 Mon, 07 Jun 2010 09:35:07 +0100 3635862 http://www.medworm.com/index.php?rid=3635707&cid=t_139811_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F06%2Fsequenom-executive-pleads-guilty-banned.html This report from Bloomberg describes a case in which a health care corporation was accused of lying to investors about the performance of a product which it hoped to market. The product was a diagnostic test, and so exaggerating its performance could have affected medical decisions, and hence patients' outcomes, as well as affecting investors' finances. Note how this case was handled.Elizabeth A. Dragon, former senior vice president of research and development at Sequenom Inc., pleaded guilty today in federal court to conspiracy to commit securities fraud for lying to investors about the company’s prenatal test for Down syndrome, U.S. officials said.Dragon admitted to making false claims to investors and analysts about the effectiveness of the San Diego-based company’s test as well as ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=3635707 Sun, 06 Jun 2010 19:32:00 +0100 3635707 http://www.medworm.com/index.php?rid=3611938&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F05%2F30%2Fyou-do-make-a-difference-in-the-dsm-5%2F Good news — you can make a difference! According to a presentation at the annual meeting of the American Psychiatric Association last week, the 8,600 comments submitted in response to the draft of the new version of the Diagnostic and Statistical Manual for Mental Disorders (called the “DSM-5″ for short — the 5 stands for the 5th edition of the book) helped spur changes in the draft. To me, this kind of change demonstrates a fundamental shift in the ability to engage in a meaningful scientific/clinical dialogue. Twenty years ago, there was no easy feedback mechanism for a project of this scale. Back then, significant time and resources would be needed in order to get legitimate and critical feedback (e.g., setting up focus groups in multiple geographic locations, ... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3611938 Sun, 30 May 2010 12:55:55 +0100 3611938 http://www.medworm.com/index.php?rid=3612076&cid=t_139811_160_f&fid=36189&url=http%3A%2F%2Fwww.skinmdblog.com%2F137%2Fhow-to-choose-the-best-dermatologist-for-you%2F Finding the best dermatologist starts with your schedule.  Doctors that do not offer weekend or evening hours are becoming a thing of the past. Most of us work crazy schedules.  Taking time off to see a “skin doctor” might be frowned upon.  So first you want to find someone with hours that fit into your schedule. Location is another important consideration.  If you have plenty of money, you might consider flying to Michigan to see Nicholas Perricone or flying to New York to see Dennis Gross.  But, you had better call the office first.  Those famous guys might not be taking any new patients. For most of us, taking a flight to have someone evaluate our skin problems is just not realistic.  Ideally, you would choose a location within an hour’s drive of your home.  Some procedure... Skin MD blogs http://www.medworm.com/rss/comments.php?id=3612076 Sun, 30 May 2010 12:32:03 +0100 3612076 http://www.medworm.com/index.php?rid=3588913&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F05%2F22%2Fpreschool-depression-real-or-imagined%2F Joan Luby, a Professor of Psychiatry in the Early Emotional Development Program at the Washington University School of Medicine, argues in a new journal article (Luby, 2010) that preschool depression is a real disorder that is important to identify early on. Preschool depression refers to preschool-aged children (between 3 and 6 years old) suffering from significant depressive symptoms that cause impairment in the child’s daily functioning and development. She argues, however, that we can’t use the adult criteria for depression, since some of those criteria wouldn’t make sense in a preschool child. A preschool child, for instance, can’t experience the loss of sexual pleasure, but they can experience a loss of enjoyment in ordinary child play activities. It makes a ... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3588913 Sat, 22 May 2010 11:06:33 +0100 3588913 http://www.medworm.com/index.php?rid=3552246&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffaith-in-healthcare-is-falling%2F2010.05.10 A newly-created index of consumer healthcare confidence has fallen steadily this year, reports The Thomson Reuters Consumer Healthcare Sentiment Index. Consumers report declining confidence in their ability to access, use, and pay for healthcare. The index, set at a baseline of 100 in December 2009, is now at 97. More consumers reported difficulty paying for services and insurance, or reported a reduction or cancellation of their insurance. More delayed or failed to fill a prescription in the past three months or canceled a diagnostic test (such as blood work, X-ray or mammogram). Further, consumers expect the situation to worsen in the next three months, including putting off elective surgery. Thomson will report figures monthly and has published their methodology online. *This bl... Better Health blogs http://www.medworm.com/rss/comments.php?id=3552246 Mon, 10 May 2010 20:00:00 +0100 3552246 http://www.medworm.com/index.php?rid=3549308&cid=t_139811_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdoes-group-health%25e2%2580%2599s-medical-home-leave-the-poor-behind%2F2010.05.10 Group Health has published two papers recently, one in Health Affairs and the other in JAMA, both extolling the virtues of its Medical Home. These follow their brief report last fall in the NEJM and the lengthy description of their model in the American Journal of Managed Care. Their model has been promoted by the Commonwealth Fund, and it is cited in the currrent issue of Lancet. The big news is that costs were a full 2% lower than conventional care, hardly a great success –- it wasn’t even statistically significant. But was even this small difference due to the Medical Home, or was it because the Medical Home patients were less likely to consume care? (more…) *This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*... Better Health blogs http://www.medworm.com/rss/comments.php?id=3549308 Mon, 10 May 2010 12:00:57 +0100 3549308 http://www.medworm.com/index.php?rid=3490728&cid=t_139811_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FN0rw9xKpgWg%2Ffda-radiation-therapy-emitting-equipment-regulation-ehr-device.html Earlier this month, the FDA released a letter announcing a new focus on radiation-emitting products.  Here's the core of the letter:In order to reduce the number of under-doses, over-doses, and misaligned exposures from therapeutic radiation the FDA is taking several steps to improve the safety and safe use of certain radiation therapy devices. Analyses of Medical Device Reports (MDRs) revealed device problems that appear to be the result of faulty design or use error that could be mitigated by the incorporation of additional safeguards. Between December 31, 1999, and February 18, 2010, FDA received 1,182 MDRs associated with the use of radiation therapy devices. Of these MDRs, linear accelerators accounted for 74%, radiation therapy treatment planning systems (RTP) accounted for 19%, and... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3490728 Wed, 21 Apr 2010 13:59:06 +0100 3490728 http://www.medworm.com/index.php?rid=3342735&cid=t_139811_113_f&fid=38494&url=http%3A%2F%2Fcuretogether.com%2Fblog%2F2010%2F03%2F08%2Fhow-to-choose-the-right-test%2F Say “Aaaahh!” (Photo credit: superfantastic) “First the doctor told me the good news: I was going to have a disease named after me.” - Steve Martin . Say you’ve decided to go ahead and get a diagnostic test done to have a more definite answer on whether you have a condition like depression. Now what? Where do you start? First off, here are some general factors to consider in choosing a test: . 1. Informativeness is basically how good the test is at telling you something useful. How informative a test is comes from both its sensitivity (how likely the test is to diagnose you as positive if you do have a condition, or avoiding false negatives) and specificity (how likely the test is to not diagnose you if you don’t have it, or avoiding false positives). The ultimate test... The Collective Well blogs http://www.medworm.com/rss/comments.php?id=3342735 Mon, 08 Mar 2010 16:13:20 +0100 3342735 http://www.medworm.com/index.php?rid=3318495&cid=t_139811_114_f&fid=34648&url=http%3A%2F%2Fhealthblawg.typepad.com%2FDave%2520Fischer%2520MITA%2520HealthBlawg%2520Interview%2520with%2520David%2520Harlow%2520022510.mp3 MITA Executive Director Dave Fischer spoke with HealthBlawg last week about industry efforts to control radiation dose in diagnostic radiology modalities such as CT.  A congressional hearing on radiation dose control took place the day after we spoke, and the FDA will be holding a hearing on diagnostic radiology issues in late March.  Earlier last week, timed in part perhaps because of the upcomng congressional committee hearing, MITA kicked off the dose check initiative, a tool for manufacturers and providers to use in better regulating diagnostic imaging radiation dose, which Dave Fischer describes in our interview.  He also referred to the CMS demonstration project on appropriateness of imaging services now underway, authorized by MIPPA.   It now seems surprising that there ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3318495 Sun, 28 Feb 2010 22:39:57 +0100 3318495 http://www.medworm.com/index.php?rid=3294669&cid=t_139811_112_f&fid=34971&url=http%3A%2F%2Fdoctorandpatient.blogspot.com%2F2010%2F02%2Flaparoscopy-for-infertile-couples.html (Source: The Patient's Doctor) The Patient's Doctor blogs http://www.medworm.com/rss/comments.php?id=3294669 Mon, 22 Feb 2010 17:14:00 +0100 3294669 http://www.medworm.com/index.php?rid=3149113&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F01%2F07%2Fintroducing-therese-borchards-new-book-beyond-blue%2F Unless you’ve been living under a rock this past year, you probably noticed that one of our regular contributors here has been Therese Borchard. However, she blogs more often and more regularly on her beliefnet.com blog, Beyond Blue. It was actually her wonderfully witty and touching writing there that led me to invite her to blog more regularly here. Therese is a rare find, combining a love of prose with a wealth of personal experiences with depression and other concerns to make for always engaging reading. So it’s no wonder she was able to bundle up that wisdom and publish her first book, Beyond Blue: Surviving Depression & Anxiety and Making the Most of Bad Genes. If you’ve enjoyed Therese’s posts either here or on her regular blog at beliefnet.com, then yo... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3149113 Thu, 07 Jan 2010 14:08:24 +0100 3149113 http://www.medworm.com/index.php?rid=3122075&cid=t_139811_87_f&fid=34925&url=http%3A%2F%2Fbestyoucanbe.blogspot.com%2F2009%2F12%2Fend-of-autism.html No, the problems of suboptimal neurodevelopment are not going away. The concept of "autism" has lasted longer than I'd expected, but the assault continues ...Syndromic autism: causes and pathogenetic pathways. [World J Pediatr. 2009] - PubMed result... Genetic syndromes, defined mutations, and metabolic diseases account for less than 20% of autistic patients. Alterations of the neocortical excitatory/inhibitory balance and perturbations of interneurons' development represent the most probable pathogenetic mechanisms underlying the autistic phenotype in fragile X syndrome and tuberous sclerosis complex. Chromosomal abnormalities and potential candidate genes are strongly implicated in the disruption of neural connections, brain growth and synaptic/dendritic morphology. Metabolic and mitocho... Be the Best You can Be blogs http://www.medworm.com/rss/comments.php?id=3122075 Fri, 25 Dec 2009 19:21:00 +0100 3122075 http://www.medworm.com/index.php?rid=3096902&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F12%2F17%2Fdsm-v-suggestions-for-change%2F With the recent announcement (PDF) by the American Psychiatric Association of a one year delay for the latest revision of the Diagnostic and Statistical Manual of Mental Disorders (the DSM, as it’s known), a new round of commentary and articles have appeared questioning the usefulness of the DSM. The DSM is used by clinicians in the mental health field to diagnose mental disorders according to the symptom lists contained in the book. The DSM is also used by researchers to ensure that when one researcher is talking about treatments for “major depression,” another researcher will use the same definition for “major depression.” I’m no defender of the DSM revision process, as previous blog entries have noted. But I’ve noticed that sometimes the criti... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3096902 Thu, 17 Dec 2009 13:09:35 +0100 3096902 http://www.medworm.com/index.php?rid=3083025&cid=t_139811_87_f&fid=34925&url=http%3A%2F%2Fbestyoucanbe.blogspot.com%2F2009%2F12%2Fwealth-and-med-choice-antipsychotics.html Interesting results, annoyingly inflammatory interpretation ...Children on Medicaid Found More Likely to Get Antipsychotics - NYTimes.comNew federally financed drug research reveals a stark disparity: children covered by Medicaid are given powerful antipsychotic medicines at a rate four times higher than children whose parents have private insurance. And the Medicaid children are more likely to receive the drugs for less severe conditions than their middle-class counterparts, the data shows.Those findings, by a team from Rutgers and Columbia, are almost certain to add fuel to a long-running debate. Do too many children from poor families receive powerful psychiatric drugs not because they actually need them — but because it is deemed the most efficient and cost-effective way to control p... Be the Best You can Be blogs http://www.medworm.com/rss/comments.php?id=3083025 Sun, 13 Dec 2009 12:59:00 +0100 3083025 http://www.medworm.com/index.php?rid=2865877&cid=t_139811_134_f&fid=36012&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FBattleDiabetes%2F%7E3%2FcZRcAVU1DrQ%2F Have you ever wondered how important your diagnostic lab results are to your diabetes control? Here’s the test you should be sure your Doctor runs for you. What if by running the right tests, your physician could determine not only where your diabetes stands right now, but also whether it is progressing or reversing? Stuart Seale, MD, Medical Director at Lifestyle Center of America and author of the book The 30-Day Diabetes Miracle, has outlined three important tests your doctor needs to do for you and why each test is crucial: Lipid Profile If you have diabetes and do not get a yearly lipid profile check up, be SURE to ask your doctor about it. This test measures the levels of total cholesterol, HDL (good) cholesterol, LDL (bad) cholesterol and triglycerides. Test results will in... Battle Diabetes Blog blogs http://www.medworm.com/rss/comments.php?id=2865877 Mon, 05 Oct 2009 23:00:29 +0100 2865877 http://www.medworm.com/index.php?rid=2842546&cid=t_139811_99_f&fid=35344&url=http%3A%2F%2Fzackarysholemberger.blogspot.com%2F2009%2F09%2Fi-dont-know-why-im-in-hospital.html Continuing to tweak my thoughts about doctor-patient diagnostic discordance (i.e. doctor says: she's in the hospital for X; patient says: my doctor told me I'm in the hospital for Y), this time for the International Conference on Communication in Healthcare to be held Oct 4-7 in Miami Beach. I will be heading to the sukkah, not to the surf (I'm arriving 10/5 if anyone wants to look me up), but I am looking forward to it nonetheless. I'm also working on an application for an AHRQ grant on the same topic so I can reproduce my Bellevue pilot study at the Johns Hopkins Hospital. (Source: Zackary Sholem Berger) Zackary Sholem Berger blogs http://www.medworm.com/rss/comments.php?id=2842546 Tue, 29 Sep 2009 15:41:00 +0100 2842546 http://www.medworm.com/index.php?rid=2800663&cid=t_139811_136_f&fid=37846&url=http%3A%2F%2Fhealthinfoispower.wordpress.com%2F2009%2F09%2F15%2Ffda-clears-vermillions-ova1-test-to-determine-likelihood-of-ovarian-cancer-in-women-with-pelvic-mass%2F The U.S. Food and Drug Administration cleared a test that can help detect ovarian cancer in a pelvic mass that is already known to require surgery. The test, called OVA1, helps patients and health care professionals decide what type of surgery should be done and by whom. First Lab Test That Can Indicate Ovarian Cancer Prior [...] (Source: Libby's H*O*P*E*) Libby's H*O*P*E* blogs http://www.medworm.com/rss/comments.php?id=2800663 Wed, 16 Sep 2009 04:45:59 +0100 2800663 http://www.medworm.com/index.php?rid=2774669&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F09%2F08%2Ftreating-internet-addiction-is-new%2F I’ve been loathe to give any additional attention to the tiny treatment center in Washington state that says it’s treating “Internet addiction” in a “first of its kind in the US” treatment program, seeing as it’s already had over 350 media mentions in the past few days, including the one below in none other than the New York Times. Apparently when you start a media snowball rolling downhill, it’s hard to stop for a moment and do any actual reporting on the topic. It is much easier to eat up the PR and repackage it with no critical eye on the claims made. One of the problems with the mainstream media’s reporting on the topic is that it’s acting as though this is the first treatment center to treat this mythical condition (I say &#8... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2774669 Tue, 08 Sep 2009 11:40:23 +0100 2774669 http://www.medworm.com/index.php?rid=2747985&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F08%2F30%2Fthe-miracle-worker-edward-m-kennedy%2F Senator Edward Kennedy pushed for equality among the underprivileged and desired reform for America’s mental health system. He was a gift from God — it was as if God had reached down from heaven through Sen. Kennedy to influence the very pinnacle of change. Following the funeral held August 29, 2009 that immersed America in sorrow — yet also in gratitude — the torch shall remain lit and glow brighter as people work in his name to finish the efforts he began in 1962. As President Obama said at his funeral, Senator Kennedy was “a champion for those who had none [...] a kind and tender hero.” If it were not for the service of the Kennedys and for their endless dedication to equality for mental and physical disabilities, Congress would not have passed the Mental... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2747985 Sun, 30 Aug 2009 14:03:56 +0100 2747985 http://www.medworm.com/index.php?rid=2678683&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F08%2F07%2Fdsm-v-update-and-transparency%2F Discussion: Is the Risk Syndrome for Psychosis Risky Business?”, this describes in detail the proposal for a new disorder called “Risk Syndrome for Psychosis.” You can access the proposed criteria for the disorder, including the text discussing characteristics, associated features, differential diagnosis, etc…. So far, there are 23 comments posted, constituting a rigorous debate about the pros and cons of the proposal. Whether or not 23 comments constitutes a “rigorous debate” anywhere, I’d point out of the seven work group members featured at the top of this article, only two of them bothered to engage in this live discussion. What’s that say about their interests in engaging in actual, legitimate scholarly discussion? (On a side note, if y... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2678683 Fri, 07 Aug 2009 12:42:50 +0100 2678683 http://www.medworm.com/index.php?rid=2653823&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F07%2F29%2Fwikipedia-vs-rorschach%2F As we noted here nearly a year ago, the Rorschach Inkblot Test images have been made available on Wikipedia. This is not a big deal, since it’s what’s called a projective test, meaning that the images themselves are not important — it’s what you see in the images that can be interesting to a psychologist. Yesterday, The New York Times noted the controversy, which has a new twist. A psychologist has posted the most common responses to each of the 10 cards in Wikipedia entry about the Rorschach Inkblot Test. This includes such astonishing revelations that most people see 2 humans in cards 2 and 3. Astonishing, I tell you. Here’s why there’s a controversy, according to the article: “The more test materials are promulgated widely, the more possibility the... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2653823 Wed, 29 Jul 2009 19:01:17 +0100 2653823 http://www.medworm.com/index.php?rid=2584276&cid=t_139811_123_f&fid=37052&url=http%3A%2F%2Fwww.youtube.com%2Fv%2FqfyNjVAC2U8%26amp%3Bhl%3Den%26amp%3Bfs%3D1%26amp%3B The latest 5th edition of the pocket guide to diagnostic tests is now available from Unbound Medicine for all mobile platforms. Here’s an iPod Touch example: Here’s a Windows Mobile example: The cost is $39.99 for all versions here is a list of links; Buy it for the iPhone in App Store here Buy it for the other platforms from Unbound Medicine here Buy the paper back book from Amazon here This is one of the rare occasions where we see an Unbound Medicine title that can be directly purchased in App Store rather than a free template to be filled by the contents when we subscribe. The new edition has several updates of the contents but no new sections seen. Of note, is that the free copy that comes with Merck Medicus is not updated [Merck Medicus told me that it's not likely in... The Pediatric PDA Blog blogs http://www.medworm.com/rss/comments.php?id=2584276 Thu, 09 Jul 2009 03:30:03 +0100 2584276 http://www.medworm.com/index.php?rid=2570668&cid=t_139811_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fmyth-prevention-and-ehrs I was just referred this article which I found to be thoughtfully crafted. Abraham Verghese is a Professor and Senior Associate Chair for the Theory and Practice of Medicine at Stanford University. I found the article interesting, by somewhat anachronistic in terms of his perception of prevention and electronic medical records. (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=2570668 Thu, 02 Jul 2009 19:24:53 +0100 2570668 http://www.medworm.com/index.php?rid=2517273&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F06%2F25%2Ftransparency-kupfer-and-the-dsm-v%2F Why is the new revision of Diagnostic and Statistical Manual of Mental Disorders (the “DSM-V”) — the reference book used to diagnose mental disorders in the U.S. — being updated in secrecy? That’s a legitimate question, and one asked by the previous head of the other modern DSM revisions (III, III-R and IV), Dr. Allen Frances in an upcoming Psychiatric Times article: The secretiveness of the DSM-V process is extremely puzzling. In my entire experience working on DSM-III, DSM-III-R, and DSM-IV, nothing ever came up that even remotely had to be hidden from anyone. There is everything to gain and absolutely nothing to lose from having a totally open process… You’d have to ask Dr. David Kupfer, the head of the DSM-V revision process, or the American Psy... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2517273 Thu, 25 Jun 2009 16:05:02 +0100 2517273 http://www.medworm.com/index.php?rid=2463637&cid=t_139811_146_f&fid=34960&url=http%3A%2F%2Fsleepdoctor.blogspot.com%2F2009%2F06%2Ffuture-of-sleep-technicians.html I'm in Seattle at the annual Sleep meeting. I'm about to go to the opening session and hear a talk by Dr. Howard Roffwarg on REM sleep.I have a few minutes before the session starts and will take the time to answer a question from a few weeks ago:A reader (TimRPSGT) asks:I have a couple of questions about the future of sleep medicine. First, how do you see the role of the sleep technologist changing over the coming years? I'm also curious bout the new approval for home studies with type 2 and 3 devices. Is there a possible business opportunity here for RPSGT's to do home studies as independent contractors for doctors?I don't see the role of sleep technologists changing much in sleep centers over the coming years. One trend that has been developing over the last several years is the movemen... sleepdoctor blogs http://www.medworm.com/rss/comments.php?id=2463637 Mon, 08 Jun 2009 14:47:00 +0100 2463637 http://www.medworm.com/index.php?rid=2441692&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F05%2F26%2Fupdate-dsm-v-major-changes%2F At the American Psychiatric Association’s annual meeting last week, a presentation covered some of the likely major changes that will be incorporated into the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders, commonly referred to as the DSM by mental health professionals. The DSM provides professionals with the symptom checklists that allow for a mental disorder diagnosis to be made. The most significant change proposed has to do with the inclusion of dimensional assessments for depression, anxiety, cognitive impairment and reality distortion that span across many major mental disorders. So a clinician might diagnose schizophrenia, but then also rate these four dimensions for the patient to characterize the schizophrenia in a more detailed and descriptive m... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2441692 Tue, 26 May 2009 18:41:05 +0100 2441692 http://www.medworm.com/index.php?rid=2405413&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F05%2F14%2Fassessing-depression-in-the-context-of-life%2F What is the difference between having a short-term, emotional crisis, an adjustment disorder, and long-term clinical depression? Well, in the hands of a sloppy mental health professional, the answer might be “nothing” — all three might be diagnosed as “major depression.” But is this really sloppy diagnosis (or, as researchers would call it, a “diagnostic challenge”), or a simple result of how mental health is typically reimbursed in the U.S.? Researchers Monroe & Reid (2009) argue that clinicians and researchers need to do a better job in evaluating depression in context of a person’s life stress. Without doing so, they argue “one cannot determine whether or not the presenting condition represents an understandable response to adve... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2405413 Thu, 14 May 2009 10:00:47 +0100 2405413 http://www.medworm.com/index.php?rid=2405066&cid=t_139811_87_f&fid=35062&url=http%3A%2F%2Ffibroresearch.blogspot.com%2F2009%2F05%2Fyet-another-study-showing-decreased.html In their study findings, titled Decreased Gray Matter Volumes in the Cingulo-Frontal Cortex and the Amygdala in Patients With Fibromyalgia, researchers at the University Hospital Münster (Germany) present the results of their investigation into the gray matter of fibromyalgia patients. Because previous studies supported the assertion that fibromyalgia involves central pain augmentation, they aimed to find out "whether structural changes in areas of the pain system are additional preconditions for the central sensitization in fibromyalgia." To do so, they performed MRI's and a neuroimaging technique called voxel based morphometry on 14 fibromyalgia patients and 14 healthy controls. They scanned and analyzed the brains of their subjects, finding that there were "[r]egional differences of th... The Fibromyalgia Research Blog blogs http://www.medworm.com/rss/comments.php?id=2405066 Tue, 12 May 2009 16:22:00 +0100 2405066 http://www.medworm.com/index.php?rid=2402885&cid=t_139811_146_f&fid=34960&url=http%3A%2F%2Fsleepdoctor.blogspot.com%2F2009%2F05%2Fqualifications-for-medical-directorship.html A reader asks:Can a Pulmonologist who is not board certified in sleep be a treating physician for the sleep center? I know the Medical Director and supervising physician has to board certified in sleep medicine.Any specialty can be a treating physician.  According to the AASM, The medical director has to be board certified or board eligible in sleep medicine, unless there is a separate "board-certified (or eligible) sleep specialist" who does the quality control/interreliability scoring. Per AASM standards, if the doctor who interprets a sleep study isn't bc/be in sleep medicine, it must be overread by a doctor who is.At the Hancock medical center sleep lab (a hospital-associated sleep lab), there is a general internist who is the medical director; I am the board certified sleep specia... sleepdoctor blogs http://www.medworm.com/rss/comments.php?id=2402885 Fri, 08 May 2009 19:17:00 +0100 2402885 http://www.medworm.com/index.php?rid=2376055&cid=t_139811_99_f&fid=35344&url=http%3A%2F%2Fzackarysholemberger.blogspot.com%2F2009%2F04%2Fshe-doesnt-know-why-shes-in-hospital.html I'm still thinking about an all-too-common hospital situation: doctor and patient don't agree on the reason why the doctors put the patient in the hospital. I'm giving a revised talk about it on Wednesday to my primary care colleagues. Comments welcome! (Source: Zackary Sholem Berger) Zackary Sholem Berger blogs http://www.medworm.com/rss/comments.php?id=2376055 Tue, 28 Apr 2009 01:17:00 +0100 2376055 http://www.medworm.com/index.php?rid=2365128&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F04%2F23%2Fcreate-your-own-mental-disorder%2F Unbelievably, we reported earlier this week that 1 in 12 teens may be addicted to video games. I say “unbelievably” because the research that comes to this stunning conclusion lacked a certain… validity. As Dr. Cheryl Olson noted succinctly on Game Politics: The concern here is labeling normal childhood behaviors as “pathological” and “addicted.” The author [Iowa State University's Prof. Douglas Gentile] is repurposing questions used to assess problem gambling in adults; however, lying to your spouse about blowing the rent money on gambling is a very different matter from fibbing to your mom about whether you played video games instead of starting your homework. So in other words, you can create your own Instant Mental Disorder ™ by simply... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2365128 Fri, 24 Apr 2009 00:50:21 +0100 2365128 http://www.medworm.com/index.php?rid=2364973&cid=t_139811_87_f&fid=34925&url=http%3A%2F%2Fbestyoucanbe.blogspot.com%2F2009%2F04%2Flink-between-autism-and-extraordinary.html Shortly after reading of an obsessive audiophile savant (definitely spectrum) I came across an Economist article exploring an old theme -- exceptional abilities in atypical minds... The link between autism and extraordinary ability | Genius locus | The Economist ... A link between artistic genius on the one hand and schizophrenia and manic-depression on the other, is widely debated. However another link, between savant syndrome and autism, is well established... A study published this week by Patricia Howlin of King’s College, London, reinforces this point. It suggests that as many as 30% of autistic people have some sort of savant-like capability in areas such as calculation or music. Moreover, it is widely acknowledged that some of the symptoms associated with autism, including poo... Be the Best You can Be blogs http://www.medworm.com/rss/comments.php?id=2364973 Thu, 23 Apr 2009 01:20:00 +0100 2364973 http://www.medworm.com/index.php?rid=2349143&cid=t_139811_125_f&fid=34820&url=http%3A%2F%2Fwww.dentalblogs.com%2Farchives%2Fadministrator%2Fcolor-strip-makes-gum-disease-diagnosis-quick-and-easy%2F Researchers from Maurice H. Kornberg School of Dentistry at Temple University have created a color-changing strip that detects periodontal disease. Studies show that the strip is as effective as traditional, invasive, more costly tests. About eighty percent of adults have some form of gum disease, so quick, accurate diagnosis would be helpful to dentists and hygienists. Because of recent research that shows gum disease causes increased risk for serious health conditions, early detection and treatment are imperative to dental and overall good health. So here’s the scoop on how the color-changing periodontal disease detecion strip works (and let’s hope they shorten that name in the future)… The new test involves an oral strip that changes color according to the level of mi... dental blog for dentists about dentistry blogs http://www.medworm.com/rss/comments.php?id=2349143 Tue, 14 Apr 2009 13:46:02 +0100 2349143 http://www.medworm.com/index.php?rid=2326618&cid=t_139811_136_f&fid=37846&url=http%3A%2F%2Fhealthinfoispower.wordpress.com%2F2009%2F04%2F07%2Fmedicare-expands-coverage-of-pet-scans-as-cancer-diagnostic-tool%2F “The Centers for Medicare & Medicaid Services (CMS) issued a final national coverage determination (NCD) to expand coverage for initial testing with positron emission tomography (PET) for Medicare beneficiaries who are diagnosed with and treated for most solid tumor cancers.  This decision applies to PET scans used to support initial diagnosis and treatment for most [...] (Source: Libby's H*O*P*E*) Libby's H*O*P*E* blogs http://www.medworm.com/rss/comments.php?id=2326618 Tue, 07 Apr 2009 21:36:08 +0100 2326618 http://www.medworm.com/index.php?rid=2306893&cid=t_139811_87_f&fid=34925&url=http%3A%2F%2Fbestyoucanbe.blogspot.com%2F2009%2F03%2Fviolence-and-natural-history-of-autism.html Ann Bauer has written four stories about her son Andrew July 2005: He's been doing well from age 12 to 17. May 2007: Andrew is 19. She tells us that he was misdiagnosed with schizophrenia, and that antipsychotic medications made him violent Mar 2008: She’s struggling, and still feels that the antipsychotic medications are responsible for Andrew’s worsening condition. Mar 2009: Andrew is dangerously violent, and his mother can’t get help in an emergency. From Mar of 2009 (emphases mine) … Ann Bauer on autism, violence | Salon Life... Andrew started life as a mostly typical child. But at 3 and a half he become remote and perseverative, sitting in a corner and staring at his own splayed hand. Eventually he was diagnosed with high-functioning autism, a label that seemed to expla... Be the Best You can Be blogs http://www.medworm.com/rss/comments.php?id=2306893 Thu, 26 Mar 2009 13:01:00 +0100 2306893 http://www.medworm.com/index.php?rid=2194843&cid=t_139811_87_f&fid=34591&url=http%3A%2F%2Fwww.kymatika.com%2Ffiles%2FLBC_Interview.mp3 Just briefly (because my hair looks terrible in it, and they made nerdy stickboy here look chubby) I was on Watchdog last night, talking about some ridiculous magical diagnosis machine. The video is here: http://www.bbc.co.uk/blogs/watchdog/2009/02/food_intolerance_test.html And there are three things to note here. One is that Julia Bradbury is weirdly hot, in a sanctimonious kind of way. The [...] (Source: badscience) badscience blogs http://www.medworm.com/rss/comments.php?id=2194843 Tue, 17 Feb 2009 18:28:49 +0100 2194843 http://www.medworm.com/index.php?rid=2056117&cid=t_139811_87_f&fid=35062&url=http%3A%2F%2Ffibroresearch.blogspot.com%2F2008%2F12%2Fbiochemical-basis-of-myofascial-pain.html Uncovering the biochemical milieu of myofascial trigger points using in vivo microdialysis: an application of muscle pain concepts to myofascial pain syndrome is the title of an article published by members of the Rehabilitation Medicine Department of the National Institutes of Health (Bethesda, MD). The article "discusses muscle pain concepts in the context of myofascial pain syndrome (MPS) and summarizes microdialysis studies that have surveyed the biochemical basis of this musculoskeletal pain condition." Myofascial pain condition is extremely common in fibromyalgia patients, though it is unclear whether MPS can cause fibromyalgia or vice versa.The pathophysiology of MPS is "only beginning to be understood due to its enormous complexity." It is considered to be characterized by the pres... The Fibromyalgia Research Blog blogs http://www.medworm.com/rss/comments.php?id=2056117 Sun, 21 Dec 2008 19:35:00 +0100 2056117 http://www.medworm.com/index.php?rid=2056588&cid=t_139811_122_f&fid=36582&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSharpBrains%2F%7E3%2F490842490%2F With three years still left until publication, the fights over the new version of the psychiatric diagnostic manual, the DSM-V, are hotting up and The New York Times has a concise article that covers most of the main point of contention. - “What you have in the end,” Mr. Shorter said, “is this process of sorting the deck of symptoms into syndromes, and the outcome all depends on how the cards fall.” - Psychiatrists involved in preparing the new manual contend that it is too early to say for sure which cards will be added and which dropped. Although I doubt the DSM committee are using that exact metaphor, it certainly illustrates the point that the process requires a certain degree of value-judgement. It's interesting, however, that the public debate is currently focused on whether ... SharpBrains blogs http://www.medworm.com/rss/comments.php?id=2056588 Sun, 21 Dec 2008 00:33:18 +0100 2056588 http://www.medworm.com/index.php?rid=1980678&cid=t_139811_87_f&fid=34925&url=http%3A%2F%2Fbestyoucanbe.blogspot.com%2F2008%2F11%2Fwarner-on-risperdal-use-in-children.html The NYT's Judith Warner meant well with a recent blog post about Risperdal use in children with "bipolar disorder" but she was ill-served by the research psychiatrists she interviewed.Here are some excerpts of her writing, with the less sensible parts removed ...Tough Choices for Tough Children - Judith Warner Blog - NYTimes.comIt was disturbing to read in The Times this week that the “atypical” antipsychotic Risperdal, a tranquilizing whopper of a drug with serious, sometimes deadly side effects, is now being widely prescribed to children with attention deficit hyperactivity disorder. .. why, according to new Food and Drug Administration data on doctors’ prescribing practices, were 16 percent of the pediatric users of Risperdal over the past three years children with A.D.H.D.?... T... Be the Best You can Be blogs http://www.medworm.com/rss/comments.php?id=1980678 Fri, 21 Nov 2008 23:30:00 +0100 1980678 http://www.medworm.com/index.php?rid=1968775&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2008%2F11%2F17%2Fdsm-v-transparency-or-secrecy%2F In a world expecting greater and greater transparency in how important medical and mental health research is conducted, should such transparency extend to the intricate workings of determining what constitutes a valid mental disorder diagnosis? That’s the question posed by two sides wrangling over how transparent the new DSM-V process should be. Robert Spitzer, a former editor, wants more transparency, while the current editor, Darrel Regier, suggests the process of should be kept private. The DSM is short for the Diagnostic and Statistical Manual of Mental Disorders, the “bible” of mental health that defines what a mental disorder is. Technically, if a disorder doesn’t appear in the book, it’s not considered a legitimate disorder nor can a therapist bill a... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=1968775 Mon, 17 Nov 2008 17:40:31 +0100 1968775 http://www.medworm.com/index.php?rid=1876564&cid=t_139811_134_f&fid=36012&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FBattleDiabetes%2F%7E3%2F421068802%2F Have you ever wondered how important your diagnostic lab results are to your diabetes control? Here’s the test you should be sure your Doctor runs for you. What if by running the right tests, your physician could determine not only where your diabetes stands right now, but also whether it is progressing or reversing? Stuart Seale, MD, Medical Director at Lifestyle Center of America and author of the book The 30-Day Diabetes Miracle, has outlined three important tests your doctor needs to do for you and why each test is crucial: Lipid Profile If you have diabetes and do not get a yearly lipid profile check up, be SURE to ask your doctor about it. This test measures the levels of total cholesterol, HDL (good) cholesterol, LDL (bad) cholesterol and triglycerides. Test results will in... Battle Diabetes Blog blogs http://www.medworm.com/rss/comments.php?id=1876564 Wed, 15 Oct 2008 01:09:35 +0100 1876564 http://www.medworm.com/index.php?rid=1856117&cid=t_139811_87_f&fid=35062&url=http%3A%2F%2Ffibroresearch.blogspot.com%2F2008%2F10%2Fstudy-reveals-subgroups-of-fibromyalgia.html This study is particularly relevance to the debate within both medical and patient communities as to the relationship between fibromyalgia and anxiety/depression. Some patients experience depression and/or anxiety before developing fibromyalgia. Some develop these symptoms long after the onset of pain and other fibromyalgia symptomsm. Still others never experience depression and anxiety at all, even as they struggle with the stress of chronic widespread pain. It also brings up questions about whether those fibromyalgia patients who do have depression or anxiety experience more severity of their pain and fatigue symptoms. (Source: The Fibromyalgia Research Blog) The Fibromyalgia Research Blog blogs http://www.medworm.com/rss/comments.php?id=1856117 Mon, 06 Oct 2008 18:41:00 +0100 1856117 http://www.medworm.com/index.php?rid=1833201&cid=t_139811_87_f&fid=34925&url=http%3A%2F%2Fbestyoucanbe.blogspot.com%2F2008%2F09%2Fcontrolling-nerve-cell-connectivity.html A day or two ago my post on Fragile X and autism research included a discussion of a general theme in current autism research ...... Bear and other scientists have also identified several drugs that seem to correct the problem. The drugs don't replace the missing brakes in the brain. Instead, they limit acceleration by reducing the activity of a group of receptors on brain cells known as mGluR5 receptors.The drugs have reversed most of the effects of Fragile X in mice. They are now being tried in humans. And at least one small study found that a single dose of a drug had an effect....The idea is that neuronal connectivity is a delicate, dynamic, balance. Too much connectivity, or too little, can both prevent cognition from working correctly.So now there's research on modulating neuronal in... Be the Best You can Be blogs http://www.medworm.com/rss/comments.php?id=1833201 Fri, 26 Sep 2008 18:31:00 +0100 1833201 http://www.medworm.com/index.php?rid=4060706&cid=t_139811_109_f&fid=34859&url=http%3A%2F%2Fblog.davemsw.com%2Farchives%2F2008%2F08%2Fis_sadness_the_same_as_depression.php This article examines the assumption that major depression is a specific illness, that it is rapidly increasing, and that a medical response is justified. I argue that major depression is not a natural entity and does not identify a homogenous group of patients. The apparent increase in major depression results from: confusing those who are ill with those who share their symptoms; the surveying of symptoms out of context; the benefits that accrue from such a diagnosis to drug companies, researchers, and clinicians; and changing social constructions around sadness and distress. Standardized medical treatment of all these individuals is neither possible nor desirable. The major depression category should be replaced by a clinical staging strategy that acknowledges the continuous distribution... Ψ Dare To Dream... blogs http://www.medworm.com/rss/comments.php?id=4060706 Sun, 17 Aug 2008 19:04:24 +0100 4060706 http://www.medworm.com/index.php?rid=1625835&cid=t_139811_136_f&fid=36051&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FCancerCommentary%2F%7E3%2F336705341%2F This report said that the practice has actually did more harm than good: However, a review of recent studies says there is no evidence that self-exams actually reduce breast cancer deaths. Instead, the practice may be doing more harm than good, since it led to almost twice as many biopsies that turned up no cancer in women who performed the self-exams, compared to women who did not do the exams. Jan Peter Kosters, Ph.D., and Peter Gotzsche, Ph.D., of the Nordic Cochrane Centre, conclude in the review: “At present, screening by breast self-examination or physical examination [by a trained health worker] cannot be recommended.” Indeed it is tricky what diagnostic tool to pursue in our hope to catch breast cancer (or any other cancer for that matter) at the earliest possible stage... Cancer Commentary blogs http://www.medworm.com/rss/comments.php?id=1625835 Wed, 16 Jul 2008 03:38:57 +0100 1625835 http://www.medworm.com/index.php?rid=4060717&cid=t_139811_109_f&fid=34859&url=http%3A%2F%2Fblog.davemsw.com%2Farchives%2F2008%2F07%2Fpsychiatry_weekly_updates_from_the_nimh_current_re.php Finally, researchers have gotten beyond finding the "one cause" or "sure-fire cure" for the various forms of mental illness. It has always been futile to find a particular biological cause. Clinicians practicing in the field have been aware of the complexity of development. It makes much more sense to look in several directions at once, for resilience, risk factors and biologically based vulnerabilities to particular symptom clusters. Mental illness is caused by a complicated combination of developmental and environmental stressors and biological strengths and weaknesses. Now, perhaps we can move beyond looking for the magic pill and focus on helping people. Psychiatry Weekly"There is a growing consensus in the field of psychiatry that many of the psychiatric illnesses, and almost certa... Ψ Dare To Dream... blogs http://www.medworm.com/rss/comments.php?id=4060717 Mon, 07 Jul 2008 15:15:39 +0100 4060717 http://www.medworm.com/index.php?rid=1481832&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2008%2F05%2F31%2Fbipolar-overdiagnosis-are-you-swayed%2F An excerpt from my book review on the new book by the Brafman brothers, Sway, in bookstores shortly: The one place the authors don’t really sway me is their attempt to explain why bipolar disorder is diagnosed so much more often than it was a decade ago. Unmentioned by the authors is the fact that many other mental disorder diagnoses have also experienced a significant increase in their use from a decade ago. They link the increase to two factors – the modern diagnostic system put into use in 1980 with the publication of the DSM-III, which “broadened” the bipolar diagnosis; and pharmaceutical advertising in the 1990s. Left out of this explanation are some of the reasons proffered by the actual researchers of the study (Moreno et. al, 2007). So what did the researchers who actual... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=1481832 Sun, 01 Jun 2008 00:35:30 +0100 1481832 http://www.medworm.com/index.php?rid=1445893&cid=t_139811_125_f&fid=34820&url=http%3A%2F%2Fwww.dentalblogs.com%2Farchives%2Fadministrator%2Fdentists-save-lives%2F Recently, local and national media seem to cover dentistry more. Maybe it’s the influence of the Extreme Makeover craze; maybe it’s all the new findings that link oral health to overall health. Whatever the cause, awareness seems to be increasing. From the local newspaper to World News and Weekly Report to Reader’s Digest, dentistry is a hot topic. Here are just a few of the startling facts that you already know: Oral cancer kills 7500 people annually, and early detection offers an 80% cure rate. Periodontal disease affects one in two Americans, and it is linked to a long list of oral health problems, including stroke, heart disease, dementia, Alzheimer’s disease, respiratory problems, diabetes complications, and low birth weight. People without teeth, which includ... dental blog for dentists about dentistry blogs http://www.medworm.com/rss/comments.php?id=1445893 Thu, 15 May 2008 12:48:12 +0100 1445893 http://www.medworm.com/index.php?rid=1437151&cid=t_139811_136_f&fid=36051&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FCancerCommentary%2F%7E3%2F288556249%2F In a separate post, I already mentioned The Pathwork® Tissue of Origin Test. It is interesting to know that Stanford University School of Medicine is investigating an investigational study of the this genomics-based diagnostic test for hard-to-identify tumors — The Pathwork® Tissue of Origin Test. The new test uses advanced genomics-based technology to help physicians determine a tumor’s origin in order to optimize cancer-specific treatment. The study will evaluate the test’s ability to impact diagnosis for cancer patients with hard-to-identify tumors, with test samples processed at the Stanford University School of Medicine’s laboratory. According to Dr. Iris Schrijver, Director of Molecular Pathology at Stanford University School of Medicine: “Hard-to-identify tumors are ... Cancer Commentary blogs http://www.medworm.com/rss/comments.php?id=1437151 Mon, 12 May 2008 09:09:03 +0100 1437151 http://www.medworm.com/index.php?rid=1432424&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2008%2F05%2F09%2Fdsm-vs-conflicts-of-interest%2F Earlier this week, the Boston Globe’s health blog dived into the issue of conflicts of interest for the latest mental disorder diagnostic manual being formulated. The diagnostic manual is known as the Diagnostic and Statistical Manual of Mental Disorders (DSM) and a fifth version of it is currently in development. How a disorder makes it into the DSM — which is used by mental health professionals and insurance companies to legitimize and pay for a mental health concern — has been the subject of numerous research papers and essays. It is a messy process, like sausage-making, and involves a combination of expert testimony (often given by the same experts who lead a subcommittee on the specific disorder), research on the disorder, and, of course, a healthy dollop of politi... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=1432424 Fri, 09 May 2008 15:27:43 +0100 1432424 http://www.medworm.com/index.php?rid=1420664&cid=t_139811_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F283936523%2F More than half the 28 new members of writers of the next edition of the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) have ties to the drug industry, according to the Center for Science in the Public Interest’s Integrity in Science Watch. The conflicts of interests were posted online by the APA last week (look here). They ranged from small to extensive. Leading the pack was William Carpenter Jr., director of Maryland Psychiatric Research Center at the University of Maryland, who over the past last five years worked as a consultant for 13 drugmakers, including Pfizer, Lilly, Wyeth, Merck, Astra Zeneca, and Bristol-Myers Squibb, according to CSPI. APA president Carolyn B. Robinowitz claimed in a statement that “we have ... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1420664 Mon, 05 May 2008 13:33:33 +0100 1420664 http://www.medworm.com/index.php?rid=1419663&cid=t_139811_87_f&fid=34925&url=http%3A%2F%2Fbestyoucanbe.blogspot.com%2F2008%2F05%2Fautism-turns-into-aspergers-how-did.html "Sam" (pseudonym) isn't "autistic" any more. Now he has "Asperger's". He used to have "autism", so what happened? What was the key intervention? Was it abstention from immunization? No, he gets poked regularly. An alternative or experimental medication? No, he's never taken any medications (unlike his sib - we treasure medications when they're valuable). An intense program of behavioral therapy? No, he's mostly inherited the fringes of the home built behavioral program his older brother needs. Dietary changes then? Vitamins, supplements, abstention from gluten? Well, he only accepts a very limited diet, but it contains a reasonable amount of gluten, wheat, etc. He's finally accepted his sister's daily multivitamin, which might help avert scurvy. A quiet, calming, nurturing home environment... Be the Best You can Be blogs http://www.medworm.com/rss/comments.php?id=1419663 Mon, 05 May 2008 04:04:00 +0100 1419663 http://www.medworm.com/index.php?rid=1372034&cid=t_139811_136_f&fid=36051&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FCancerCommentary%2F%7E3%2F270393563%2F This came to my attention a while back, but for some reason got buried in my inbox. So sorry Laura! Two new oncology tests — classifying metastatic cancer and identifying patients with estrogen receptor positive (ER+) breast cancer who are at high risk of recurrence as well as unlikely to respond favorably to standard adjuvant endocrine therapy — from AviaraDx, Inc. are now state-approved in New York. The tests, based on proprietary AviaraDx molecular technologies, are New York state-approved and available through the company’s CAP-certified CLIA laboratory. Both can utilize small formalin-fixed and paraffin-embedded (FFPE) tissue samples easily available from imaging-guided needle biopsies. CancerTYPE ID™ and H/I™ (HOXB13/IL17BR) are the two said tests from AviaraDx, Inc... Cancer Commentary blogs http://www.medworm.com/rss/comments.php?id=1372034 Tue, 15 Apr 2008 02:24:02 +0100 1372034 http://www.medworm.com/index.php?rid=1344210&cid=t_139811_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2008%2F04%2F01%2Fare-we-really-that-ill%2F I meant to blog about this a few days ago, but time got away from me and here it is April already! Christopher Lane over at The (N.Y.) Sun has written an in-depth editorial asking if we Americans are as sick as some of the mental health professional experts would have us believe. It’s a legitimate question, as the number of diagnosable disorders has expanded over the years (but technically hasn’t changed since the release of the original DSM-IV in 1994, 14 years ago). In the editorial, Lane examines why 112 new disorders were added to the DSM-III, which was originally published in 1980 (28 years ago, not that anyone is counting). His cursory look at the complex and unscientific process that went into the DSM-III is interesting, but ultimately unsatisfying: Incredibly, the... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=1344210 Tue, 01 Apr 2008 22:12:37 +0100 1344210 http://www.medworm.com/index.php?rid=1336672&cid=t_139811_87_f&fid=34925&url=http%3A%2F%2Fbestyoucanbe.blogspot.com%2F2008%2F03%2Fbreakthrough-in-understanding-genetics.html A major publication in Science on the genetics of schizophrenia is summarized in Gordon's Notes Gordon's Notes: What is schizophrenia? Not what we thought. ... note only 15% percent of "schizophrenics" fit this pattern. I'll summarize the key implications: Schizophrenia is not a disease. It's the name given a fairly large number of unique disorders of brain development that have, among their endpoints, social withdrawal, hallucinations, and fixed beliefs. A good number of cases of "autism" and "schizophrenia" are different manifestations of overlapping sets of mutations. There may be"no genes for most instances autism and schizophrenia". There are sets of large scale mutations that are similar between close genetic relatives, but simil... Be the Best You can Be blogs http://www.medworm.com/rss/comments.php?id=1336672 Sun, 30 Mar 2008 02:42:00 +0100 1336672 http://www.medworm.com/index.php?rid=1296082&cid=t_139811_87_f&fid=34925&url=http%3A%2F%2Fbestyoucanbe.blogspot.com%2F2008%2F03%2Finteractive-autism-network-research.html Discussion Groups are focused on the IAN research project. It will be tough to keep them on topic -- they'd need heavy moderation to survive. I'll take a look at them later and comment on how well that's working out. (Source: Be the Best You can Be) Be the Best You can Be blogs http://www.medworm.com/rss/comments.php?id=1296082 Wed, 12 Mar 2008 00:57:00 +0100 1296082 http://www.medworm.com/index.php?rid=4060727&cid=t_139811_109_f&fid=34859&url=http%3A%2F%2Fblog.davemsw.com%2Farchives%2F2008%2F03%2Fpsychiatric_comorbidity_of_internet_addiction_in_c.php While still excluded from the DSM IV TR, Internet addiction has graduated to a subject worthy of research. And not surprisingly, like all other addictive behaviors, what I like to call "temporary feel goods", are associated with a lot of other diagnoses. Avoiding negative emotions has serious consequences, beyond even addictions. CNS Spectrums "Internet addiction were more likely to have MDD, dysthymic disorder, social phobia and adult ADHD than their unaffected counterparts. Adult ADHD is the most significant predictor for Internet addiction, followed by depressive disorders. Social phobia, however, was not correlated with Internet addiction in our sample after controlling for depressive disorders and adult ADHD. Further, depressive disorders and Internet addiction were associated in th... Ψ Dare To Dream... blogs http://www.medworm.com/rss/comments.php?id=4060727 Sat, 01 Mar 2008 17:18:23 +0100 4060727 http://www.medworm.com/index.php?rid=1268444&cid=t_139811_87_f&fid=35062&url=http%3A%2F%2Ffibroresearch.blogspot.com%2F2008%2F02%2Fstudy-suggests-fibromyalgia-pain-is.html This study evaluated 305 chronic pain patients (CPPs) admitted to The Rosomoff Pain Center (Miami, FL). All were administered the NPS, a diagnostic tool designed to assess the distinct pain qualities associated with neuropathic pain, and were given a diagnosis on the basis of a physical examination and all available test results.Using patients known to have neuropathic or non-neuropathic pain conditions as a reference, esearchers were able to derive "an NPS cut-off score above which CPPs would be classified as having neuropathic pain." Patients who had diagnoses of myofascial pain syndromes, spinal stenosis, epidural fibrosis, fibromyalgia, complex regional pain syndromes, and failed back surgery syndrome, a predicted NPS score was calculated and compared with the cut-off score.The NPS app... The Fibromyalgia Research Blog blogs http://www.medworm.com/rss/comments.php?id=1268444 Fri, 29 Feb 2008 16:25:00 +0100 1268444 http://www.medworm.com/index.php?rid=1199992&cid=t_139811_87_f&fid=35062&url=http%3A%2F%2Ffibroresearch.blogspot.com%2F2008%2F02%2Fimmunological-changes-in-fibromyalgia.html The newest issue of the medical journal Neuroimmunomodulation [2008 Feb 1;14(5):272-280] includes the results of a study conducted by Department of Anesthesiology of Ludwig Maximilians University, Munich, Germany. The study address immunological changes in chronic pain patients, specifically complex regional pain syndrome (CRPS) and fibromyalgia (FMS), both of which the researchers describe as "chronic pain syndromes occurring in highly stressed individuals."Despite the known connection between the nervous system and immune cells, information on distribution of lymphocyte subsets under stress and pain conditions is limited. Lymphocytes are white blood cells that play a critical role in the body's defenses. They include T cells, B cells, and natural killer cells. They also modulate the acti... The Fibromyalgia Research Blog blogs http://www.medworm.com/rss/comments.php?id=1199992 Mon, 04 Feb 2008 18:27:00 +0100 1199992 http://www.medworm.com/index.php?rid=1909222&cid=t_139811_177_f&fid=38133&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FTubalReversalBlog%2F%7E3%2F286469518%2Flaparoscopy-recap.html Why Some Patients Choose To Have Screening Laparoscopy Tubal ligation procedures vary in the severity of injury occurring to the fallopian tubes. Although most tubal ligations are reversible, there are some cases where tubal reversal is not possible. If the operative report from your tubal ligation indicates there may be a problem in repairing the [...] (Source: Tubal Reversal Blog) Tubal Reversal Blog blogs http://www.medworm.com/rss/comments.php?id=1909222 Sun, 13 Jan 2008 00:35:22 +0100 1909222 http://www.medworm.com/index.php?rid=1126436&cid=t_139811_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F209955350%2F Most of the 27 members of an American Psychiatric Association task force that is updating the psychiatrist’s bible - the Diagnostic and Statistical Manual of Mental Disorders, or DSM, have financial ties to pharma, and several failed to disclose significant aspects of their relationships when the panel was announced last July, according to a recent story in US News and World Report. The APA sought to pursue the “most transparent” policy possible, after the last edition of the DSM contained newly named disorders that were seized on by drugmakers and a 2006 study showed that more than half of the researchers who worked on that manual had at least one financial tie to pharma, the mag writes. But the summaries of the disclosure statements that were recently released to the pu... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1126436 Wed, 02 Jan 2008 15:46:34 +0100 1126436 http://www.medworm.com/index.php?rid=1117728&cid=t_139811_146_f&fid=34960&url=http%3A%2F%2Fsleepdoctor.blogspot.com%2F2007%2F12%2Fidtfs-can-no-longer-perform-sleep.html Sleep Review reports that:Hotels/Motels Not Appropriate for Sleep Studies, CMS SaysNew regulatory standards for independent diagnostic testing facilities released by CMS last month are scheduled to take effect January 1, 2008.Among the standards is one that rules out the use of hotels and motels for performing sleep studies.More information about the standard can be located here. I believe that this ruling only applies to IDTF's. As an AASM accreditation site visitor, I have inspected a university-owned sleep lab that was based in a hotel. It was a nice operation. I don't agree with this CMS decision, though it will affect only a few sleep labs. (Source: sleepdoctor) sleepdoctor blogs http://www.medworm.com/rss/comments.php?id=1117728 Wed, 26 Dec 2007 15:59:00 +0100 1117728 http://www.medworm.com/index.php?rid=1909233&cid=t_139811_177_f&fid=38133&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FTubalReversalBlog%2F%7E3%2F286469534%2Flaparoscopy-tubal-reversal.html Tubal Ligation Operations Vary Tubal ligation operations vary in the amount of damage they cause to the fallopian tubes. Tubal coagulation (cauterization) tends to damage more of the tube than tubal ligation and resection or tubal clips/rings. Burning or cauterizing the fallopian tubes with a monopolar coagulator is more destructive than with a bipolar coagulator. With [...] (Source: Tubal Reversal Blog) Tubal Reversal Blog blogs http://www.medworm.com/rss/comments.php?id=1909233 Fri, 14 Dec 2007 20:59:11 +0100 1909233 http://www.medworm.com/index.php?rid=1082916&cid=t_139811_87_f&fid=35060&url=http%3A%2F%2Fwww.healthnewsblog.com%2Fcgi-bin%2Fhnblog.pl%3Fhnblog%3D1127071 A new 256-slice CT machine from Philips creates some stunning images that medical professionals can use to find abnormalities and disease. The BBC reports that the new machine produces "3D body images of unprecedented clarity" while also reducing X-ray exposure by as much as 80%. The new 256-slice CT machine takes large numbers of X-ray pictures, and combines them using computer technology to produce the final detailed images. It also generates images in a fraction of the time of other scanners: a full body scan takes less than a minute. The Philips machine was unveiled at the Radiological Society of North America. Because the images are 3D they can be rotated and viewed from different directions - giving doctors the greatest possible help in looking for signs of abnormalities or dis... HealthNewsBlog.com blogs http://www.medworm.com/rss/comments.php?id=1082916 Wed, 28 Nov 2007 03:00:00 +0100 1082916 http://www.medworm.com/index.php?rid=1045951&cid=t_139811_87_f&fid=35062&url=http%3A%2F%2Ffibroresearch.blogspot.com%2F2007%2F11%2F1-in-4-chronic-pain-patients-has.html Vitamin D deficiency has been known for a while to be common in fibromyalgia patients, and research has even linked it with anxiety and depression in fibromyalgia. New research, however, shows that Vitamin D deficiency may in fact cause worsening of chronic pain in general. The American Society of Anesthesiologists recently released results of a Mayo Clinic study that shows that 1/4 of chronic pain patients have inadequate blood levels of vitamin D. The study also suggests that such a deficiency can possibly contribute to the severity of chronic pain. Their study showed that patients who have vitamin D deficiency needed a higher dose of morphine for a longer time in order to alleviate their pain.Researchers recorded the serum vitamin D levels of 267 adults undergoing outpatient treatment f... The Fibromyalgia Research Blog blogs http://www.medworm.com/rss/comments.php?id=1045951 Thu, 22 Nov 2007 18:51:00 +0100 1045951 http://www.medworm.com/index.php?rid=944609&cid=t_139811_87_f&fid=35062&url=http%3A%2F%2Ffibroresearch.blogspot.com%2F2007%2F10%2Fabnormalities-found-in-nerve-cells-in.html In this month's Clinical Rheumatology [2007 Oct 3], researchers at Dongguk University College of Medicine in South Korea published the results of a blinded study conducted to "determine if there are any abnormal electron microscopic (EM) findings in the skin of fibromyalgia syndrome (FMS) patients, which might contribute to or be due to the increased pain sensitivity seen in this condition."They collected skin biopsy samples from 13 fibromyalgia patients and 5 control subjects, which were read by an individual who did not have any knowledge of whether the biopsy was from a study participant or not. All five skin biopsies from healthy controls "showed relatively even distribution of variegated sized unmyelinated axons sheathed well by complicatedly folded Schwann cell membranes." However, i... The Fibromyalgia Research Blog blogs http://www.medworm.com/rss/comments.php?id=944609 Fri, 12 Oct 2007 00:01:00 +0100 944609 http://www.medworm.com/index.php?rid=758699&cid=t_139811_87_f&fid=35062&url=http%3A%2F%2Ffibroresearch.blogspot.com%2F2007%2F07%2Fpet-scans-show-multidisciplinary.html The results of a pilot study published in Rheumatology International (July 20, 2007) show that clinical improvement in fibromyalgia can occur when a multi-disciplinary treatment program is able to increase a fibromyalgia patient's limbic metabolism. According to researchers at Washington Hospital Center, Washington, DC, this indicates that there is limbic system involvement in fibromyalgia syndrome.Aberrant central neurological functioning is believed to contribute to the abnormal sensations of fibromyalgia (FM). This pilot study sought to determine if alterations in regional brain metabolism from baseline occur in FM after undergoing a multidisciplinary therapeutic regimen. Regional brain metabolic activity was estimated using (18)F-fluorodeoxyglucose positron emission tomography ((18)FDG... The Fibromyalgia Research Blog blogs http://www.medworm.com/rss/comments.php?id=758699 Sun, 22 Jul 2007 18:34:00 +0100 758699 http://www.medworm.com/index.php?rid=758700&cid=t_139811_87_f&fid=35062&url=http%3A%2F%2Ffibroresearch.blogspot.com%2F2007%2F07%2Fbrain-derived-neurotrophic-factor.html In the October 2007 issue of the Journal of Psychiatric Research a study conducted by researchers at the Department of Psychiatry and Psychotherapy, University of Tuebingen, Germany, will discuss their research into the levels of brain-derived neurotrophic factor in fibromyalgia patients and their conclusion that fibromyalgia is not a psychiatric or psychosomatic disorder. The article, Increased BDNF serum concentration in fibromyalgia with or without depression or antidepressants, describes the results of the department's pilot study.Fibromyalgia (FM) is still often viewed as a psychosomatic disorder. However, the increased pain sensitivity to stimuli in FM patients is not an "imagined" histrionic phenomena. Pain, which is consistently felt in the musculature, is related to specific abnor... The Fibromyalgia Research Blog blogs http://www.medworm.com/rss/comments.php?id=758700 Sun, 22 Jul 2007 18:19:00 +0100 758700 http://www.medworm.com/index.php?rid=758701&cid=t_139811_87_f&fid=35062&url=http%3A%2F%2Ffibroresearch.blogspot.com%2F2007%2F07%2Fchanges-in-fibromyalgia-tender-point.html The study summarized in Tender point count and total myalgic score in fibromyalgia: changes over a 28-day period (Rheumatology International, July 20, 2007), investigates tender point count (TPC) and total myalgic score (TMS) in fibromyalgia patients. Researchers at Health and Rehabilitation Sciences Research Institute at the University of Ulster, Northern Ireland, explain that TPC and TMS are used to monitor fibromyalgia patients' conditions. They studied 24 fibromyalgia patients in order to determine how stable these measures were over time and how well they reflected the patients' own experiences and perceptions of their condition.When they entered the study, all patients completed the Fibromyalgia Impact Questionnaire (FIQ) and a visual analogue scale (VAS) measuring well-being. They w... The Fibromyalgia Research Blog blogs http://www.medworm.com/rss/comments.php?id=758701 Sun, 22 Jul 2007 18:08:00 +0100 758701 http://www.medworm.com/index.php?rid=758702&cid=t_139811_87_f&fid=35062&url=http%3A%2F%2Ffibroresearch.blogspot.com%2F2007%2F07%2Fis-fibromyalgia-really-rheumatologic.html The nature and categorization of fibromyalgia has perplexed researchers for years. Researchers at the Department of Rheumatology of the National Hospital Rikshospitalet, Oslo, Norway, published an article this month in Rheumatology International (July 20, 2007) which is the latest in the controversy over whether or not fibromyalgia can be classified as a rheumatologic illness.They describe fibromyalgia as "a medically unexplained or functional somatic syndrome (FSS)" with two classification criteria: chronic widespread pain (CWP) and the finding of 11 out of 18 tender points (TP). It overlaps, they write, with other functional somatic syndromes. Ten of these FSS's aside from fibromyalgia also include chronic fatigue syndrome, myofascial pain syndromes and irritable bowel syndrome. This mak... The Fibromyalgia Research Blog blogs http://www.medworm.com/rss/comments.php?id=758702 Sun, 22 Jul 2007 17:53:00 +0100 758702 http://www.medworm.com/index.php?rid=536650&cid=t_139811_87_f&fid=34925&url=http%3A%2F%2Fbestyoucanbe.blogspot.com%2F2007%2F04%2Fdiagnosing-autism-more-frequently-means.html The Strib, our local paper (now on life support) had an impressive graph on the front page yesterday. Alas, the (feeble) web site lacks the graph, which was a typical exponential growth curve implying that within 20 years every child will carry the diagnosis of autism [4].So what does the increase, and the current estimate from a recent CDC study of 1/150 children, mean? First, here's some text from the article (emphases mine) ...Autism everywhereBy David Peterson, Star TribuneLast update: April 09, 2007 – 11:55 PM... The number of kids classed as autistic is exploding. A recent study by the federal Centers for Disease Control and Prevention reported that autism is found in one in 150 children -- and researchers involved in the study say that may be an understatement. In Minnesota school... Be the Best You can Be blogs http://www.medworm.com/rss/comments.php?id=536650 Wed, 11 Apr 2007 15:29:00 +0100 536650 http://www.medworm.com/index.php?rid=490659&cid=t_139811_131_f&fid=35007&url=http%3A%2F%2Fbooks.mcgraw-hill.com%2Fmedical%2Fommbid%2Fblog%2F%3Fp%3D149 This article provides further support to the idea that perhaps, in the future, we will be performing part of the screening for inborn errors of metabolism by nuclear magnetic resonance (NMR). In this article, the authors used NMR and desorption electrospray ionization mass spectrometry to succesfully identify abnormal concentrations of metabolites in samples from patients with samples from individual patients with argininosuccinic aciduria, classic homocystinuria, classic methylmalonic acidemia, maple syrup urine disease, phenylketonuria and tyrosinemia type II. Thank you very much in advance for your contributions to this blog (Click on login to register and post a message). Philippe Campeau, MD Resident in Medical Genetics at McGill University OMMBID Blog Administrator (Source: The OMMBI... The OMMBID Blog blogs http://www.medworm.com/rss/comments.php?id=490659 Thu, 22 Mar 2007 13:57:08 +0100 490659 http://www.medworm.com/index.php?rid=495919&cid=t_139811_136_f&fid=35293&url=http%3A%2F%2Fprostate-help.blogs.com%2Fprostatehelp%2F2007%2F03%2Fthe_utility_of_.html Link: The Utility Of Magnetic Resonance Imaging And Spectroscopy For Predicting Insignificant Prostate Cancer: An Initial Analysis. UroToday.com- Up to one-half of patients undergoing active surveillance for prostate cancer (CaP) will convert to active treatment. Indeed, many in this subgroup... (Source: Prostate-Help) Prostate-Help blogs http://www.medworm.com/rss/comments.php?id=495919 Thu, 22 Mar 2007 01:08:03 +0100 495919 http://www.medworm.com/index.php?rid=486797&cid=t_139811_87_f&fid=35062&url=http%3A%2F%2Ffibroresearch.blogspot.com%2F2007%2F03%2Fdiagnostic-criteria-for-myofascial.html An article in this month's Clinical Journal of Pain (2007 Mar-Apr; 23(3):278-86) summarizes the results of a literature review done at the Uiversities of Exeter and Plymouth, UK. This review aimed to investigate the criteria used to diagnose myofascial trigger point (MTrP) pain syndrome, a painful condition often experienced by people with fibromyalgia as well as those without. The researchers searched electronic databases, looking for relevant empirical research, and found 93 articles that met their inclusion criteria. They assessed "(1) the individual criterion and criteria combinations used to diagnose MTrP pain syndrome; (2) the cited "authoritative" publications and (3) the criteria recommended by the authoritative publications as being essential for MTrP pain syndrome diagnosis."The ... The Fibromyalgia Research Blog blogs http://www.medworm.com/rss/comments.php?id=486797 Tue, 13 Mar 2007 16:05:00 +0100 486797 http://www.medworm.com/index.php?rid=486812&cid=t_139811_87_f&fid=35062&url=http%3A%2F%2Ffibroresearch.blogspot.com%2F2007%2F02%2Fcritical-analysis-of-tender-points-in.html A new method for quantifying and assessing fibromyalgia tender points has been developed by doctors at the Northwestern University's Center for Pain Studies (Chicago, IL). Published in this month's Pain Medicine (2007 Mar;8(2):147-156), the results of their study show a clear and measurable differentiation between tender points in fibromyalgia patients and non-fibromyalgia patients. Their critical assessment of the American College of Rheumatology's (ACR) diagnostic criteria for fibromyalgia involved 25 fibromyalgia patients and 31 health controls. Using an algometer (a device that measures pressure threshold) they applied pressure to the 18 ACR tender points and five sham points. They used the patients' responses to give them an "algometric total score" (the sum of the patient's average p... The Fibromyalgia Research Blog blogs http://www.medworm.com/rss/comments.php?id=486812 Wed, 21 Feb 2007 00:58:00 +0100 486812 http://www.medworm.com/index.php?rid=486817&cid=t_139811_87_f&fid=35062&url=http%3A%2F%2Ffibroresearch.blogspot.com%2F2007%2F02%2Fchildren-with-fibromyalgia-report-more.html The creation of a system for evaluating the impacts of fibromyalgia on the lives of children and teens with fibromyalgia, as well as the outcome of treatments, is discussed in an article in February's Health and Quality of Life Outcomes (2007 Feb 12;5(1):9). Standardized outcome measures for clinical trials in fibromyalgia are being developed to measure pain, generic health-related quality of life, fatigue, sleep quality, and physical function but no such measures exist for pediatric fibromyalgia.Because of this lack of a standardized way to evaluate fibromyalgia impact on children and teens, researchers analyzed the "feasibility, reliability, and validity of the PedsQL 4.0 (Pediatric Quality of Life Inventory) Generic Core Scales, PedsQL Multidimensional Fatigue Scale, and PedsQL Rheumato... The Fibromyalgia Research Blog blogs http://www.medworm.com/rss/comments.php?id=486817 Thu, 15 Feb 2007 18:12:00 +0100 486817 http://www.medworm.com/index.php?rid=4060800&cid=t_139811_109_f&fid=34859&url=http%3A%2F%2Fblog.davemsw.com%2Farchives%2F2006%2F09%2Fthe_new_asylums_redux.php There is news today of a new study about mental health problems in prison and jails. The information shows a much bigger problem than previously reported. MSNBC.com More than half of America's prison and jail inmates have symptoms of a mental health problem, the Justice Department estimated Wednesday. But fewer than one-third of those with problems are getting treatment behind bars. The study by the department's Bureau of Justice Statistics also found the incidence of symptoms much higher among women than men. Compared to inmates without symptoms, these mentally troubled prisoners were more likely to have been jailed before, to get into a fight behind bars, to have been physically or sexually abused in the past and to have drug problems, the bureau said. But troubled inmates were no m... Ψ Dare To Dream... blogs http://www.medworm.com/rss/comments.php?id=4060800 Fri, 08 Sep 2006 01:33:59 +0100 4060800